Organization
LAKE PULMONARY CRITICAL CARE
Active
Other names
Lakeside Sleep Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA LYNN BARBER (OPERATIONS MANAAGER)
(352) 742-4447
Entity
Organization
Contact information
Practice address
1876 NIGHTINGALE LN, TAVARES, FL 32778-4359
(352) 343-9943
(352) 343-0661
Mailing address
1876 NIGHTINGALE LN, TAVARES, FL 32778-4359
(352) 343-9943
(352) 343-0661
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5933487104
TAX ID #
FL
01
—
V3034
BCBS OF FLORIDA
FL
Enumeration date
07/28/2006
Last updated
01/13/2011
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