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General NPI Number Information
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NPI Number | 1588439756
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Entity Type | Organization
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Legal Business Name | PREMIER ALLERGIST OF FLORIDA LLC
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1890 LPGA BLVD STE 255
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-7207
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Country | US
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Telephone | 386-673-1323
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Fax | 386-676-7448
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Provider Business Mailing Address
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Address Line | 2500 LEGACY DR STE 200
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City | FRISCO
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State | TX
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Zip | 75034-1844
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Country | US
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Telephone | 469-209-8355
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Fax |
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Authorized Official
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Title or Position | VP RCM
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Name | SAMUEL ALTMAN
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Credential |
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Telephone | 469-209-8355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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