Provider Demographics
NPI:1255006375
Name:LEHIGH PULMONARY ASSOCIATES, INC
Entity type:Organization
Organization Name:LEHIGH PULMONARY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EL-GENDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-369-3333
Mailing Address - Street 1:PO BOX 3445
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33918-3445
Mailing Address - Country:US
Mailing Address - Phone:239-369-3333
Mailing Address - Fax:239-369-4837
Practice Address - Street 1:14651 PALM BEACH BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-2331
Practice Address - Country:US
Practice Address - Phone:239-369-3333
Practice Address - Fax:239-369-4837
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEHIGH PULMONARY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000657702Medicaid