Provider Demographics
NPI:1730255787
Name:PULMONARY MEDICINE ASSOCIATES
Entity type:Organization
Organization Name:PULMONARY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-895-9060
Mailing Address - Street 1:10101 W COLONIAL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4213
Mailing Address - Country:US
Mailing Address - Phone:407-895-9060
Mailing Address - Fax:407-895-9010
Practice Address - Street 1:10101 W COLONIAL DR STE 102
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4213
Practice Address - Country:US
Practice Address - Phone:407-895-9060
Practice Address - Fax:407-895-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66300207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty