Provider Demographics
NPI:1285821124
Name:ASTHMA ALLERGY & IMMUNOLOGY PA
Entity Type:Organization
Organization Name:ASTHMA ALLERGY & IMMUNOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IMTIAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-846-4000
Mailing Address - Street 1:903 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4941
Mailing Address - Country:US
Mailing Address - Phone:407-846-4000
Mailing Address - Fax:407-846-4808
Practice Address - Street 1:903 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4941
Practice Address - Country:US
Practice Address - Phone:407-846-4000
Practice Address - Fax:407-846-4808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE91171Medicare UPIN