1679261887 NPI number — ASTHMA AND ALLERGY ASSOCIATES OF FL PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679261887 NPI number — ASTHMA AND ALLERGY ASSOCIATES OF FL PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASTHMA AND ALLERGY ASSOCIATES OF FL PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679261887
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7800 SW 87TH AVE STE C340
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33173-3570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-595-0109
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2925 AVENTURA BLVD STE 308
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-932-5662
Provider Business Practice Location Address Fax Number:
305-932-1011
Provider Enumeration Date:
04/26/2023

Additional Information

Authorized Official

Authorized Official Last Name:
MONTES
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER ENROLLMENT SPECIALIST
Authorized Official Telephone Number:
305-595-0109

Provider Taxonomy Codes

  • Taxonomy code: 207KA0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 373589303 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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