Florida Pediatric Pulmonology LLC

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

ME73220 Issued in FL

Legal business name

FLORIDA PEDIATRIC PULMONOLOGY LLC

Practice address

15740 New Hampshire CT
# B
Fort Myers, FL 33908-4173

Phone

(239) 466-1243

NPI assigned

Apr 3, 2007

Last updated

Feb 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Luis Faverio, M.D.

Title

President

Phone

(239) 466-1243

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203724800000",
    "number": "1386765386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7518",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339117518",
            "telephone_number": "239-931-7262",
            "fax_number": "239-931-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15740 NEW HAMPSHIRE CT",
            "address_2": "# B",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084173",
            "telephone_number": "239-466-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PEDIATRIC PULMONOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-02-23",
        "status": "A",
        "authorized_official_last_name": "FAVERIO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-466-1243",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "ME73220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Pulmonology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatric Pulmonology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2008; 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.