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General NPI Number Information
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NPI Number | 1891597050
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Entity Type | Organization
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Legal Business Name | LUNGMD, PA
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 4469 S CONGRESS AVE STE 106
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City | PALM SPRINGS
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State | FL
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Zip | 33461-4726
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Country | US
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Telephone | 561-954-2731
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Fax | 561-257-0227
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Provider Business Mailing Address
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Address Line | 5260 HOMELAND RD
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City | LAKE WORTH
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State | FL
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Zip | 33449-8467
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Country | US
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Telephone | 248-228-0036
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Fax | 561-257-0227
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LUIS PENA-HERNANDEZ
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Credential | MD FCCP
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Telephone | 248-228-0036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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