Provider Demographics
NPI:1073823092
Name:ASTHMA AND ALLERGY ASSOCIATES OF FLORIDA
Entity Type:Organization
Organization Name:ASTHMA AND ALLERGY ASSOCIATES OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-595-0109
Mailing Address - Street 1:7800 SW 87TH AVE
Mailing Address - Street 2:SUITE C-340
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-0109
Mailing Address - Fax:305-595-7092
Practice Address - Street 1:7800 SW 87TH AVE
Practice Address - Street 2:SUITE C-340
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3570
Practice Address - Country:US
Practice Address - Phone:305-595-0109
Practice Address - Fax:305-595-7092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105569363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty