Healthcare Provider Details
I. General information
NPI: 1093779696
Provider Name (Legal Business Name): ALLERGY & ASTHMA ASSOCIATES OF SOUTH FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2006
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9035 SUNSET DR SUITE 304
MIAMI FL
33173-3441
US
IV. Provider business mailing address
11880 SW 40TH ST SUITE 304
MIAMI FL
33175-3584
US
V. Phone/Fax
- Phone: 305-279-3366
- Fax: 305-271-3355
- Phone: 305-223-8808
- Fax: 305-223-8974
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAIME
LANDMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 305-223-8808