MEDICARE: PULMONARY PRACTICE ASSOCIATES MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
3	207RP1001X	Pulmonary Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114929643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULMONARY PRACTICE ASSOCIATES MD PA

Provider Business Mailing Address
First Line	:	1075 TOWN CENTER DR
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8360
Country	:	US
Telephone Number	:	386-917-0333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1075 TOWN CENTER DR
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8360
Country	:	US
Telephone Number	:	386-917-0333
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	NATASHA SIERRA
Credential	:
Telephone Number	:	386-917-0333

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	06/10/2025

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