Provider Demographics
NPI:1285058784
Name:TAMPA BAY PULMONARY AND SLEEP MEDICINE PA
Entity type:Organization
Organization Name:TAMPA BAY PULMONARY AND SLEEP MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-655-2500
Mailing Address - Street 1:402 NOLAND DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5709
Mailing Address - Country:US
Mailing Address - Phone:813-655-2500
Mailing Address - Fax:813-655-2519
Practice Address - Street 1:402 NOLAND DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5709
Practice Address - Country:US
Practice Address - Phone:813-655-2500
Practice Address - Fax:813-655-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty