Provider Demographics
NPI:1639196728
Name:THE LUNG CLINIC, P.A.
Entity Type:Organization
Organization Name:THE LUNG CLINIC, P.A.
Other - Org Name:LUNG CLINIC, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAUKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP
Authorized Official - Phone:407-944-3500
Mailing Address - Street 1:1115 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4405
Mailing Address - Country:US
Mailing Address - Phone:407-944-3500
Mailing Address - Fax:407-944-3503
Practice Address - Street 1:1115 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4405
Practice Address - Country:US
Practice Address - Phone:407-944-3500
Practice Address - Fax:407-944-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49612207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370115800Medicaid
FL370115800Medicaid
FL370115800Medicaid