MEDICARE: ALLERGY ASSOCIATES OF THE PALM BEACHES, P.A.

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	ME34195	FL
2	207K00000X	Allergy & Immunology Physician	ARNP2029482	FL
3	207K00000X	Allergy & Immunology Physician	ARNP2993372	FL
4	207K00000X	Allergy & Immunology Physician	058623	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y7113	OTHER	FL	MEDICARE
2	K0216	OTHER	FL	MEDICARE PTAN
3	E7878Z	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	H67966	OTHER	FL	UPIN
5	S51831	OTHER	FL	UPIN

General Provider Information

NPI Number	:	1720082753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY ASSOCIATES OF THE PALM BEACHES, P.A.

Provider Business Mailing Address
First Line	:	840 US HIGHWAY 1
Second Line	:	SUITE 235
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3830
Country	:	US
Telephone Number	:	561-626-2006
Fax Number	:	561-624-9718

Provider Business Practice Location Address
First Line	:	840 US HWY #1
Second Line	:	SUITE 235
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408
Country	:	US
Telephone Number	:	561-626-2006
Fax Number	:	561-624-9718

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK RODGER STEIN
Credential	:	M.D.
Telephone Number	:	561-626-2006

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	02/12/2013

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