Healthcare Provider Details

I. General information

NPI: 1184312324
Provider Name (Legal Business Name): ASTHMA & ALLERGY ASSOCIATES OF FL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 E COMMERCIAL BLVD STE 305
FORT LAUDERDALE FL
33308-3769
US

IV. Provider business mailing address

7800 SW 87TH AVE STE C340
MIAMI FL
33173-3570
US

V. Phone/Fax

Practice location:
  • Phone: 954-492-5525
  • Fax: 954-492-1755
Mailing address:
  • Phone: 305-595-0109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PATRICIA MONTES
Title or Position: PROVIDER ENROLLMENT SPECIALIST
Credential:
Phone: 305-595-0109