Provider Demographics
NPI:1215367115
Name:PULMONARY SLEEP AND CRITICAL CARE SPECIALISTS PL
Entity Type:Organization
Organization Name:PULMONARY SLEEP AND CRITICAL CARE SPECIALISTS PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FABRIZIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-613-1777
Mailing Address - Street 1:4235 KINGS HIGHWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980
Mailing Address - Country:US
Mailing Address - Phone:941-613-1777
Mailing Address - Fax:941-613-1779
Practice Address - Street 1:4235 KINGS HWY
Practice Address - Street 2:STE 103
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-8421
Practice Address - Country:US
Practice Address - Phone:941-613-1777
Practice Address - Fax:941-613-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty