Healthcare Provider Details
I. General information
NPI: 1154367654
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CARE OF FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2006
Last Update Date: 04/10/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1740 SE 18TH ST SUITE 1002
OCALA FL
34471-5408
US
IV. Provider business mailing address
1740 SE 18TH ST SUITE 1002
OCALA FL
34471-5408
US
V. Phone/Fax
- Phone: 352-622-1126
- Fax: 352-622-2391
- Phone: 352-622-1126
- Fax: 352-622-2391
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: MRS.
LORA
ANN
MARRS
Title or Position: PRACTICE MANAGER
Credential: CPC, CPPM
Phone: 352-622-1126