Provider Demographics
NPI:1902004161
Name:PULMONARY PRACTICE OF ORLANDO, P.A
Entity Type:Organization
Organization Name:PULMONARY PRACTICE OF ORLANDO, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-515-8585
Mailing Address - Street 1:PO BOX 568671
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32856-8671
Mailing Address - Country:US
Mailing Address - Phone:407-515-8585
Mailing Address - Fax:407-515-8584
Practice Address - Street 1:1697 LAKE BALDWIN LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6722
Practice Address - Country:US
Practice Address - Phone:407-515-8585
Practice Address - Fax:407-515-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty