Provider Demographics
NPI:1174963326
Name:HOF PULM & SLEEP, INC
Entity type:Organization
Organization Name:HOF PULM & SLEEP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:F
Authorized Official - Last Name:BAKEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-274-8047
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0129
Mailing Address - Country:US
Mailing Address - Phone:863-419-7509
Mailing Address - Fax:863-419-7824
Practice Address - Street 1:171 WEBB DR STE 2
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3944
Practice Address - Country:US
Practice Address - Phone:863-419-7509
Practice Address - Fax:863-419-7824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101230207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty