Provider Demographics
NPI:1467816918
Name:SMART SINUS AND ALLERGY FLORIDA LLC
Entity Type:Organization
Organization Name:SMART SINUS AND ALLERGY FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JOFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-278-1885
Mailing Address - Street 1:822 A1A N
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3260
Mailing Address - Country:US
Mailing Address - Phone:847-278-1885
Mailing Address - Fax:630-635-2496
Practice Address - Street 1:1100 E WOODFIELD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5116
Practice Address - Country:US
Practice Address - Phone:847-278-1885
Practice Address - Fax:630-635-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125271207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty