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Contact Information

LAKE PULMONARY CRITICAL CARE P A
1876 NIGHTINGALE LN
TAVARES, FL32778-4359
 Phone: 352-742-4447
 Fax: 352-742-4448
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Adult Health

363LA2200X 50 Nurse Practitioner
 

Critical Care Medicine

364SC0200X 89 Certified Clinical Nurse Specialist
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Sleep Medicine

207RS0012X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for LAKE PULMONARY CRITICAL CARE P A

NPI Number 1851372494
LBN Legal business name LAKE PULMONARY CRITICAL CARE P A
Authorized official JESSICA BARBER - (OPERATIONS MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/10/2005
Last updated 01/13/2011 - About 15 years ago
Identifiers
FL License # ARNP9218919
FL Medicaid 254399100
FL Other 21518 BCBS PROVIDER NUMBER
FL Other 2900100538 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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