Provider Demographics
NPI:1427294974
Name:PULMONARY INSTITUTE, P.A.
Entity type:Organization
Organization Name:PULMONARY INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA-IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-405-0722
Mailing Address - Street 1:8803 FUTURES DR STE 7
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9076
Mailing Address - Country:US
Mailing Address - Phone:407-219-5936
Mailing Address - Fax:407-480-3455
Practice Address - Street 1:8803 FUTURES DR STE 7
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9076
Practice Address - Country:US
Practice Address - Phone:407-219-5936
Practice Address - Fax:407-480-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93134207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI34698Medicare UPIN