Healthcare Provider Details

I. General information

NPI: 1518924273
Provider Name (Legal Business Name): ALLERGY & ASTHMA ASSOC OF WEST BOCA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 NW EXECUTIVE CENTER DR SUITE 100
BOCA RATON FL
33431-8579
US

IV. Provider business mailing address

2385 NW EXECUTIVE CENTER DR SUITE 100
BOCA RATON FL
33431-8579
US

V. Phone/Fax

Practice location:
  • Phone: 561-451-0200
  • Fax: 561-451-0700
Mailing address:
  • Phone: 561-451-0200
  • Fax: 561-451-0700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME0053447
License Number StateFL

VIII. Authorized Official

Name: DR. HOWARD M WEINER
Title or Position: PHYSICIAN PRESIDENT
Credential: MD MPH
Phone: 561-451-0200