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NPI Code Detail

MEDICARE: LAKE PULMONARY CRITICAL CARE

MEDICARE: LAKE PULMONARY CRITICAL CARE
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1V3034OTHERFLBCBS OF FLORIDA
25933487104OTHERFLTAX ID #

General Provider Information

NPI Number : 1396759023
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE PULMONARY CRITICAL CARE
Provider Business Mailing Address
First Line : 1876 NIGHTINGALE LN
Second Line :
City : TAVARES
State : FL
Zip : 32778-4359
Country : US
Telephone Number : 352-343-9943
Fax Number : 352-343-0661
Provider Business Practice Location Address
First Line : 1876 NIGHTINGALE LN
Second Line :
City : TAVARES
State : FL
Zip : 32778-4359
Country : US
Telephone Number : 352-343-9943
Fax Number : 352-343-0661
Authorized Official
Title or Position : OPERATIONS MANAAGER
Name : MS. JESSICA LYNN BARBER
Credential :
Telephone Number : 352-742-4447
Provider Enumeration Date : 07/28/2006
Last Update Date : 01/13/2011

Similar Medicare Providers

1043205552 — ROSEMARY A CIRELLI MD
Practice Location Address:
1876 NIGHTINGALE LN
TAVARES, FL
32778-4359
Practice Phone: 352-742-4447
Practice Fax: 352-748-4448
1841285343 — FRANCISCO J MONTOYA MD
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1851372494 — LAKE PULMONARY CRITICAL CARE P A
Practice Location Address:
1876 NIGHTINGALE LN
TAVARES, FL
32778-4359
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Practice Fax: 352-742-4448
1679773725 — DR. ALAA G. ISKANDAR M.D.
Practice Location Address:
1876 NIGHTINGALE LN
TAVARES, FL
32778-4359
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Practice Fax: 352-742-4448
1265667331 — DR. ALBA DAMARIS RIVERA-DIAZ MD, LND
Practice Location Address:
1876 NIGHTINGALE LN
TAVARES, FL
32778-4359
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1184850802 — LAKE PULMONARY CRITICAL CARE
Practice Location Address:
1876 NIGHTINGALE LN
TAVARES, FL
32778-4359
Practice Phone: 352-742-4447
Practice Fax: 352-742-4448

Directions to “LAKE PULMONARY CRITICAL CARE ” Practice Location

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