Provider Demographics
NPI:1760689541
Name:LUNG ASSOCIATES PA
Entity Type:Organization
Organization Name:LUNG ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMPERTAAP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-741-8633
Mailing Address - Street 1:203 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1013
Mailing Address - Country:US
Mailing Address - Phone:941-741-8633
Mailing Address - Fax:941-741-8632
Practice Address - Street 1:203 3RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1013
Practice Address - Country:US
Practice Address - Phone:941-741-8633
Practice Address - Fax:941-741-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053985174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCC5225OtherRAILROAD MEDICARE
FL09282ZMedicare ID - Type UnspecifiedINDIVIDUAL
FLCC5225OtherRAILROAD MEDICARE
FLE67467Medicare UPIN