Provider Demographics
NPI:1427120484
Name:LEHIGH PULMONARY ASSOCIATES, INC
Entity type:Organization
Organization Name:LEHIGH PULMONARY ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position: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:N 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 1:2625 LEE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1569
Practice Address - Country:US
Practice Address - Phone:239-369-3333
Practice Address - Fax:239-369-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85931174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000657700Medicaid
FLK4103Medicare ID - Type Unspecified