Provider Demographics
NPI:1043228307
Name:PULMONARY CONSULTANTS OF SW FL PA
Entity Type:Organization
Organization Name:PULMONARY CONSULTANTS OF SW FL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-574-2644
Mailing Address - Street 1:1031 SE 9TH PL
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3003
Mailing Address - Country:US
Mailing Address - Phone:239-574-2644
Mailing Address - Fax:239-574-1451
Practice Address - Street 1:1031 SE 9TH PL
Practice Address - Street 2:UNIT 2
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3003
Practice Address - Country:US
Practice Address - Phone:239-574-2644
Practice Address - Fax:239-574-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259708000Medicaid
FL45464OtherBC/BS
FL2357954OtherAETNA
FLH1501OtherRAILROAD PROVIDER NUMBER
FL45464Medicare PIN