Provider Demographics
NPI:1174689574
Name:ALLERGY ASTHMA SPECIALISTS, PA
Entity Type:Organization
Organization Name:ALLERGY ASTHMA SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAGNESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-339-3002
Mailing Address - Street 1:661 E ALTAMONTE DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5105
Mailing Address - Country:US
Mailing Address - Phone:407-339-3002
Mailing Address - Fax:407-260-5039
Practice Address - Street 1:661 E ALTAMONTE DR
Practice Address - Street 2:SUITE 315
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5105
Practice Address - Country:US
Practice Address - Phone:407-339-3002
Practice Address - Fax:407-260-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379739200Medicaid
FL379739200Medicaid