# FLORIDA PEDIATRIC PULMONOLOGY LLC

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

## Provider details

- **NPI number:** 1386765386
- **Authorized official:** LUIS FAVERIO M.D. (PRESIDENT)
- **Authorized official phone:** (239) 466-1243

## Contact information

- **Practice address:** 15740 NEW HAMPSHIRE CT, \# B, FORT MYERS, FL 33908-4173
- **Practice address phone:** (239) 466-1243
- **Mailing address:** PO BOX 7518, FORT MYERS, FL 33911-7518
- **Mailing address phone:** (239) 931-7262
- **Mailing address fax:** (239) 931-7397

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0214X | Pediatric Pulmonology Physician | ME73220 | FL | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 02/23/2008