Organization Active NPI

Lomba MD PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Lehigh Acres, FL
National Provider Identifier
1184865206
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
LOMBA MD PA
Practice address
1500 Lee Blvd
Lehigh Acres, FL 33936-4835
Phone
(239) 368-4439
NPI assigned
Mar 19, 2009
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Fernando L Lomba, MDNPI 1043282049
Title
President
Phone
(941) 766-4267

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

1500 Lee Blvd
Lehigh Acres, FL 33936-4835

Mailing address

PO Box 144333
Orlando, FL 32814-4333
Phone (407) 422-9831

Other identifiers 1

IdentifierTypeStateIssuer
274181402MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000101 FL Part B Supplier - Clinic/Group Practice 5597742437 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Davenport, FL; Lake Wales, FL; Port Charlotte, FL; Punta Gorda, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

420 Tamiami Trl S
Venice, FL 34285
Phone (941) 483-7150

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1184865206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144333",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328144333",
            "telephone_number": "407-422-9831",
            "fax_number": "407-648-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LEE BLVD",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364835",
            "telephone_number": "239-368-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMBA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "LOMBA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-766-4267",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274181402",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.