Healthcare Provider Details

I. General information

NPI: 1174689574
Provider Name (Legal Business Name): ALLERGY ASTHMA SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 E ALTAMONTE DR SUITE 315
ALTAMONTE SPRINGS FL
32701-5105
US

IV. Provider business mailing address

661 E ALTAMONTE DR SUITE 315
ALTAMONTE SPRINGS FL
32701-5105
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-3002
  • Fax: 407-260-5039
Mailing address:
  • Phone: 407-339-3002
  • Fax: 407-260-5039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PRAGNESH H PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-339-3002