MEDICARE: ARTHRITIS AUTOIMMUNE AND ALLERGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	ME64530	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417148032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHRITIS AUTOIMMUNE AND ALLERGY

Provider Business Mailing Address
First Line	:	1893 N CLYDE MORRIS BLVD
Second Line	:	SUITE 110
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5535
Country	:	US
Telephone Number	:	386-676-0307
Fax Number	:	386-677-7842

Provider Business Practice Location Address
First Line	:	1893 N CLYDE MORRIS BLVD
Second Line	:	SUITE 110
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5535
Country	:	US
Telephone Number	:	386-676-0307
Fax Number	:	386-677-7842

Authorized Official
Title or Position	:	OWNER
Name	:	YONG H TSAI
Credential	:	M.D.
Telephone Number	:	386-676-0307

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	04/15/2009

Similar Medicare Providers

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Practice Location Address:

1893 N CLYDE MORRIS BLVD , SUITE 110
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32117-5535

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1275521221 — MARK ALLEN RINER M.D.
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1346338811 — AIMEE WIENER ARNP
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DAYTONA BEACH, FL
32117-5535

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Practice Fax: 386-677-7842

1013242247 — MR. BRIAN JAMISON HOLLOWAY LMT
Practice Location Address:

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1497067797 — DR. ELIZABETH ANN STEPHENSON AP
Practice Location Address:

1893 N CLYDE MORRIS BLVD , SUITE 110
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1013226273 — MRS. NICOLE ANCTIL MEYER P.T.
Practice Location Address:

1893 N CLYDE MORRIS BLVD
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32117-5535

Practice Phone: 386-676-0307
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Directions to “ARTHRITIS AUTOIMMUNE AND ALLERGY ” Practice Location

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