Provider Demographics
NPI:1205043494
Name:PEDIATRIC PULMONARY AND ALLERGY ASSOC.
Entity Type:Organization
Organization Name:PEDIATRIC PULMONARY AND ALLERGY ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-589-0805
Mailing Address - Street 1:1 SW 129TH AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1706
Mailing Address - Country:US
Mailing Address - Phone:954-589-0805
Mailing Address - Fax:954-668-2205
Practice Address - Street 1:1 SW 129TH AVE STE 308
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1706
Practice Address - Country:US
Practice Address - Phone:954-589-0805
Practice Address - Fax:954-668-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOC0106391174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty