MEDICARE: ALLERGY, ASTHMA & SINUS ASSOCIATES, 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	207KA0200X	Allergy Physician	ME92264	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16010	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992001473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY, ASTHMA & SINUS ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	2510 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1601
Country	:	US
Telephone Number	:	954-717-1919
Fax Number	:	954-717-2528

Provider Business Practice Location Address
First Line	:	2510 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1601
Country	:	US
Telephone Number	:	954-717-1919
Fax Number	:	954-717-2528

Authorized Official
Title or Position	:	MD
Name	:	SHAHID RANDHAWA
Credential	:	M.D.
Telephone Number	:	954-717-1919

Provider Enumeration Date	:	02/01/2011
Last Update Date	:	09/10/2012

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