MEDICARE: ALLERGY AND ASTHMA CARE PA

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	207K00000X	Allergy & Immunology Physician

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	:	1477854057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY AND ASTHMA CARE PA

Provider Business Mailing Address
First Line	:	405 S SHORE CREST DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3625
Country	:	US
Telephone Number	:	813-388-6855
Fax Number	:	813-364-8107

Provider Business Practice Location Address
First Line	:	2407 CYPRESS RIDGE BLVD
Second Line	:	SUITE A
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-6312
Country	:	US
Telephone Number	:	813-388-6855
Fax Number	:	813-364-8107

Authorized Official
Title or Position	:	OWNER AND PROVIDER
Name	:	DR. SAMRIDHI NARULA NALLAMSHETTY
Credential	:	MD
Telephone Number	:	813-388-6855

Provider Enumeration Date	:	11/12/2010
Last Update Date	:	11/12/2010

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