Provider Demographics
NPI:1922131184
Name:SINUS & NASAL INSTITUTE OF FL PA
Entity Type:Organization
Organization Name:SINUS & NASAL INSTITUTE OF FL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-573-0074
Mailing Address - Street 1:550 94TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-1108
Mailing Address - Country:US
Mailing Address - Phone:727-573-0074
Mailing Address - Fax:727-573-0076
Practice Address - Street 1:550 94TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2406
Practice Address - Country:US
Practice Address - Phone:727-573-0074
Practice Address - Fax:727-573-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6315Medicare ID - Type UnspecifiedGROUP NUMBER