Provider Demographics
NPI:1093779696
Name:ALLERGY & ASTHMA ASSOCIATES OF SOUTH FLORIDA PA
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES OF SOUTH FLORIDA PA
Other - Org Name:FLORIDA CENTER FOR ALLERGY & ASTHMA CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-223-8808
Mailing Address - Street 1:11880 SW 40TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3584
Mailing Address - Country:US
Mailing Address - Phone:305-223-8808
Mailing Address - Fax:305-223-8974
Practice Address - Street 1:9035 SUNSET DR
Practice Address - Street 2:SUITE 304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3441
Practice Address - Country:US
Practice Address - Phone:305-279-3366
Practice Address - Fax:305-271-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99134BOtherMEDICARE PTAN
FL251675600Medicaid
FL99134OtherMEDICARE PTAN
FL99134Medicare ID - Type Unspecified
FL99134OtherMEDICARE PTAN