Provider Demographics
NPI:1346299005
Name:ASTHMA ALLERGY CARE CENTER PL
Entity Type:Organization
Organization Name:ASTHMA ALLERGY CARE CENTER PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:KACHARALAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-804-6002
Mailing Address - Street 1:1301, S. INTERNATIONAL PARKWAY
Mailing Address - Street 2:SUITE 1011
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1410
Mailing Address - Country:US
Mailing Address - Phone:407-804-6002
Mailing Address - Fax:407-804-8777
Practice Address - Street 1:1301, S. INTERNATIONAL PARKWAY
Practice Address - Street 2:SUITE 1011
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1410
Practice Address - Country:US
Practice Address - Phone:407-804-6002
Practice Address - Fax:407-804-8777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASTHMA ALLERGY CARE CENTER PL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-09
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062618207K00000X, 207KA0200X, 207RA0201X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378852100Medicaid
F81976Medicare UPIN
27975Medicare ID - Type Unspecified
FL27975YMedicare PIN