1699753079 NPI number — ALLERGY & ASTHMA CONSULTANTS PA

Table of content: (NPI 1699753079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699753079 NPI number — ALLERGY & ASTHMA CONSULTANTS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY & ASTHMA CONSULTANTS 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:
1699753079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
793 DOUGLAS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTAMONTE SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32714-2566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-862-5824
Provider Business Mailing Address Fax Number:
407-774-0464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
793 DOUGLAS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTAMONTE SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32714-2566
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-862-5824
Provider Business Practice Location Address Fax Number:
407-774-0464
Provider Enumeration Date:
01/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWARTZ
Authorized Official First Name:
EUGENE
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT / M.D.
Authorized Official Telephone Number:
407-862-5824

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: 100722200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com