MEDICARE: ADVANCED ALLERGY, ASTHMA & SINUS CARE, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YS0123X	Facial Plastic Surgery Physician	ME117560	FL
2	363LF0000X	Family Nurse Practitioner	ARNP2508082	FL
3	207YX0602X	Otolaryngic Allergy Physician

General Provider Information

NPI Number	:	1154575942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED ALLERGY, ASTHMA & SINUS CARE, P.A.

Provider Business Mailing Address
First Line	:	4495 MILITARY TRL STE 202
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-4818
Country	:	US
Telephone Number	:	561-627-6277
Fax Number	:	561-626-6277

Provider Business Practice Location Address
First Line	:	4495 MILITARY TRL
Second Line	:	SUITE 202
City	:	JUPITER
State	:	FL
Zip	:	33458
Country	:	US
Telephone Number	:	561-627-6277
Fax Number	:	561-626-6277

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JEAN-PAUL ELIAS AZZI
Credential	:	M.D.
Telephone Number	:	561-627-6277

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	08/29/2018

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