Provider Demographics
NPI:1043429038
Name:PULMONARY ASSOCIATES OF PEMBROKE PINES, INC
Entity Type:Organization
Organization Name:PULMONARY ASSOCIATES OF PEMBROKE PINES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LORN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-227-5176
Mailing Address - Street 1:1725 E HIGHWAY 50 STE C
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5188
Mailing Address - Country:US
Mailing Address - Phone:352-243-5651
Mailing Address - Fax:
Practice Address - Street 1:703 N FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1006
Practice Address - Country:US
Practice Address - Phone:954-443-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97464Medicare ID - Type Unspecified