Provider Demographics
NPI:1295756799
Name:LUNG SPECIALISTS OF PALM BEACH, PL
Entity type:Organization
Organization Name:LUNG SPECIALISTS OF PALM BEACH, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:DE OLAZABAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-694-1101
Mailing Address - Street 1:3400 BURNS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4325
Mailing Address - Country:US
Mailing Address - Phone:561-694-1101
Mailing Address - Fax:561-694-1102
Practice Address - Street 1:3400 BURNS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4325
Practice Address - Country:US
Practice Address - Phone:561-694-1101
Practice Address - Fax:561-694-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 42106207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty