1427120484 NPI number — LEHIGH PULMONARY ASSOCIATES, INC

Table of content: (NPI 1427120484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427120484 NPI number — LEHIGH PULMONARY ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEHIGH PULMONARY ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FLORIDA LUNG & SLEEP ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427120484
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3445
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
N FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33918-3445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-369-3333
Provider Business Mailing Address Fax Number:
239-369-4837

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2625 LEE BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LEHIGH ACRES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33971-1569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-369-3333
Provider Business Practice Location Address Fax Number:
239-369-4837
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EL-GENDY
Authorized Official First Name:
ALAA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
239-369-3333

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ME85931 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000657700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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