Provider Demographics
NPI:1922288315
Name:ORLANDO PULMONARY AND CRITICAL CARE ASSOCIATES INC
Entity Type:Organization
Organization Name:ORLANDO PULMONARY AND CRITICAL CARE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:AKULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-425-3362
Mailing Address - Street 1:930 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1203
Mailing Address - Country:US
Mailing Address - Phone:407-425-3362
Mailing Address - Fax:407-425-8824
Practice Address - Street 1:930 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1203
Practice Address - Country:US
Practice Address - Phone:407-425-3362
Practice Address - Fax:407-425-8824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL604612278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057950500Medicaid
FL14528YOtherMEDICARE ID
FL14528YOtherMEDICARE ID