# LOMBA MD PA

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

## Provider details

- **NPI number:** 1639810591
- **Authorized official:** FERNANDO LUIS LOMBA MD (OWNER)
- **Authorized official phone:** (941) 766-4120

## Contact information

- **Practice address:** 540 THE RIALTO, VENICE, FL 34285-2900
- **Practice address phone:** (941) 483-7157
- **Mailing address:** PO BOX 742291, ATLANTA, GA 30374-2291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2022
- **Last updated:** 04/05/2022