Provider Demographics
NPI:1003681263
Name:PREMIER ALLERGIST OF FLORIDA LLC
Entity Type:Organization
Organization Name:PREMIER ALLERGIST OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP RCM
Authorized Official - Prefix:
Authorized Official - First Name:WARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-209-8355
Mailing Address - Street 1:4975 PRESTON PARK BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5152
Mailing Address - Country:US
Mailing Address - Phone:469-209-8355
Mailing Address - Fax:
Practice Address - Street 1:5460 LENA RD UNIT 101
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-9500
Practice Address - Country:US
Practice Address - Phone:941-251-3584
Practice Address - Fax:941-254-7640
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER ALLERGIST OF FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty