NPIMap

Organization Active NPI

Lomba MD PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Lake Wales, FL
National Provider Identifier
1336719699
Registry record updated Jun 29, 2021
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
410 S 11TH St
Lake Wales, FL 33853-4203
Phone
(863) 676-1433
NPI assigned
Jun 29, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Fernando Luis LombaNPI 1043282049
Title
Owner
Phone
(941) 766-4120

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Lomba MD PA11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

NPPES NPI Registry

Primary practice location

410 S 11TH St
Lake Wales, FL 33853-4203

Mailing address

PO Box 742291
Atlanta, GA 30374-2291

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 29, 2021.

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1336719699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742291",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-676-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMBA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "LOMBA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-766-4120"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.