Organization
LAKE PULMONARY CRITICAL CARE
Active
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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