NPIMap

Organization Active NPI

Pulmonary Group of Central Florida, LLC

  • Pulmonary Disease Physician
  • Leesburg, FL
National Provider Identifier
1346409802
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME94696 Issued in FL
Legal business name
PULMONARY GROUP OF CENTRAL FLORIDA, LLC
Practice address
1038 W North Blvd Ste 102
Leesburg, FL 34748
Phone
(352) 315-1627
Fax
(352) 326-8744
NPI assigned
Jun 9, 2008
Last updated
Jan 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Authorized official

Name
Jose L Diaz, MDNPI 1659318608
Title
Medical Director
Phone
(352) 315-1627

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X ME94696 FL
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X ME94696 FL Primary

Addresses

Primary practice location

1038 W North Blvd Ste 102
Leesburg, FL 34748

Mailing address

1038 W North Blvd Ste 102
Leesburg, FL 34748-5077
Phone (352) 315-1627

Other practice location 1

501 Medical Plaza Dr # 102
Leesburg, FL 34748-7324
Phone (352) 360-3152

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080930000094 FL Part B Supplier - Clinic/Group Practice 7113094327 Receives reassigned benefits from 8 practitioners
Practice locations: Leesburg, FL

National Provider Directory

National Provider Directory

Locations

2214 Highway 44 W
Inverness, FL 34453
Phone (352) 341-2500

1038 W North Blvd
Leesburg, FL 34748

1038 W North Blvd
Ste 102
Leesburg, FL 34748
Phone (352) 315-1627

501 Medical Plaza Dr
#102
Leesburg, FL 34748
Phone (352) 315-1627

620 S Lake St
Ste 1
Leesburg, FL 34748
Phone (352) 360-3152

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1346409802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 W NORTH BLVD STE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485077",
            "telephone_number": "352-315-1627",
            "fax_number": "352-326-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 W NORTH BLVD STE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34748",
            "telephone_number": "352-315-1627",
            "fax_number": "352-326-8744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Medical Plaza Dr # 102",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347487324",
            "country_code": "US",
            "telephone_number": "352-360-3152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PULMONARY GROUP OF CENTRAL FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-315-1627",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME94696",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME94696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.