Organization
SUNIL N LALLA MD PA
Active
Organization
SUNIL N LALLA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNIL N LALLA M.D., P.A (OWNER)
(239) 561-2202
Entity
Organization
Contact information
Practice address
14171 METROPOLIS AVE, 202, FORT MYERS, FL 33912-4335
(239) 561-2202
(239) 561-3099
Mailing address
14171 METROPOLIS AVE, 202, FORT MYERS, FL 33912-4335
(239) 561-2202
(239) 561-3099
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME061581
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006N
BCFL GROUP
FL
01
—
15080
BCBS
FL
05
—
370308800
—
FL
Enumeration date
09/11/2005
Last updated
08/19/2009
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