MEDICARE: LUNGMD, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207QA0505X	Adult Medicine Physician
2	207R00000X	Internal Medicine Physician
3	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1891597050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUNGMD, PA

Provider Business Mailing Address
First Line	:	5260 HOMELAND RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33449-8467
Country	:	US
Telephone Number	:	248-228-0036
Fax Number	:	561-257-0227

Provider Business Practice Location Address
First Line	:	4469 S CONGRESS AVE STE 106
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-4726
Country	:	US
Telephone Number	:	561-954-2731
Fax Number	:	561-257-0227

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	LUIS PENA-HERNANDEZ
Credential	:	MD FCCP
Telephone Number	:	248-228-0036

Provider Enumeration Date	:	03/26/2025
Last Update Date	:	03/26/2025

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Directions to “LUNGMD, PA ” Practice Location

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