Provider Demographics
NPI:1518924273
Name:ALLERGY & ASTHMA ASSOC OF WEST BOCA PA
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA ASSOC OF WEST BOCA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:561-451-0200
Mailing Address - Street 1:2385 NW EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8579
Mailing Address - Country:US
Mailing Address - Phone:561-451-0200
Mailing Address - Fax:561-451-0700
Practice Address - Street 1:2385 NW EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8579
Practice Address - Country:US
Practice Address - Phone:561-451-0200
Practice Address - Fax:561-451-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053447207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07460Medicare PIN