Provider Demographics
NPI:1346626462
Name:MY ALLERGY LIFE LLC
Entity Type:Organization
Organization Name:MY ALLERGY LIFE LLC
Other - Org Name:ALL LABS SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPERDUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-308-9028
Mailing Address - Street 1:1615 S CONGRESS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6300
Mailing Address - Country:US
Mailing Address - Phone:239-308-9028
Mailing Address - Fax:954-239-3902
Practice Address - Street 1:1615 S CONGRESS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6300
Practice Address - Country:US
Practice Address - Phone:239-308-9028
Practice Address - Fax:954-239-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRQHGVOtherBCBS