# LINCARE PULMONARY REHAB SERVICES OF FLORIDA, PL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376807610
- **Authorized official:** JENNIFER L PEDERSEN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (727) 431-8273

## Contact information

- **Practice address:** 823 DUNLAWTON AVE STE A, PORT ORANGE, FL 32127-4221
- **Practice address phone:** (386) 322-4552
- **Practice address fax:** (386) 322-4856
- **Mailing address:** 19387 US HIGHWAY 19 N, CLEARWATER, FL 33764-3102
- **Mailing address phone:** (727) 431-8261
- **Mailing address fax:** (877) 524-9504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/02/2012
- **Last updated:** 09/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | FC718C | PTAN | FL |