Provider Demographics
NPI:1114905148
Name:THE EAR NOSE AND THROAT SURGICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:THE EAR NOSE AND THROAT SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-644-4883
Mailing Address - Street 1:133 BENMORE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4143
Mailing Address - Country:US
Mailing Address - Phone:407-644-4883
Mailing Address - Fax:407-644-3697
Practice Address - Street 1:133 BENMORE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4143
Practice Address - Country:US
Practice Address - Phone:407-644-4883
Practice Address - Fax:407-644-3697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C31310OtherRR MEDICARE
CB0799OtherRR MEDICARE
24437OtherBC/BS GROUP NUMBER
FL375028100Medicaid
CB0800OtherRR MEDICARE
FL375028100Medicaid
24437OtherBC/BS GROUP NUMBER
24437COtherBC/BS GROUP NUMBER
CB0799OtherRR MEDICARE
CB0800OtherRR MEDICARE
C31310OtherRR MEDICARE
24437Medicare PIN