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General NPI Number Information
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NPI Number | 1811041015
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA SPECIALISTS OF NORTH FLORIDA PA
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 1895 KINGSLEY AVE SUITE 401
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City | ORANGE PARK
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State | FL
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Zip | 32073-4466
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Country | US
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Telephone | 904-272-5251
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Fax | 904-276-0459
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Provider Business Mailing Address
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Address Line | 1895 KINGSLEY AVE SUITE 401
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City | ORANGE PARK
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State | FL
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Zip | 32073-4466
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Country | US
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Telephone | 904-730-4870
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Fax | 904-276-0459
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Authorized Official
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Title or Position | PHYSICIAN
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Name | PATRICK JOSEPH DEMARCO III
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Credential | MD
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Telephone | 904-272-5251
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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 | ME25318
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | ME86337
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License Number State | FL
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