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General NPI Number Information
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NPI Number | 1962497545
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Entity Type | Organization
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Legal Business Name | LAKE PULMONARY & SLEEP DISORDERS CLINIC P.A.
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 501 MEDICAL PLAZA DR SUITE 102
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City | LEESBURG
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State | FL
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Zip | 34748-7324
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Country | US
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Telephone | 352-728-0709
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Fax | 352-728-6460
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Provider Business Mailing Address
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Address Line | 501 MEDICAL PLAZA DR SUITE 102
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City | LEESBURG
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State | FL
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Zip | 34748-7324
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Country | US
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Telephone | 352-728-0709
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Fax | 352-728-0709
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FELIPE O ORTIZ
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Credential | MD
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Telephone | 352-728-0709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0041828
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License Number State | FL
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