Basic Information
Provider Information
NPI: 1952713836
EntityType: 2
ReplacementNPI:  
OrganizationName: LINCARE INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ADULT & PEDIATRIC SPECIALISTS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13987 US HIGHWAY 19 N
Address2:  
City: CLEARWATER
State: FL
PostalCode: 33764
CountryCode: US
TelephoneNumber: 7274318462
FaxNumber: 8775249504
Practice Location
Address1: 5333 COMMERCE SQUARE DR
Address2: STE J
City: INDIANAPOLIS
State: IN
PostalCode: 462378627
CountryCode: US
TelephoneNumber: 8778209391
FaxNumber: 3178830230
Other Information
ProviderEnumerationDate: 05/27/2014
LastUpdateDate: 12/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NANNIE
AuthorizedOfficialFirstName: BRIAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: AUTHORIZED OFFICIAL
AuthorizedOfficialTelephone: 7275307700
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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