Provider Demographics
NPI:1821786054
Name:ASTHMA & ALLERGY ASSOCIATES OF FL PA
Entity Type:Organization
Organization Name:ASTHMA & ALLERGY ASSOCIATES OF FL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-595-0109
Mailing Address - Street 1:7800 SW 87TH AVE STE C-340
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-0109
Mailing Address - Fax:
Practice Address - Street 1:13550 SW 120TH ST STE 520
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7505
Practice Address - Country:US
Practice Address - Phone:305-256-1994
Practice Address - Fax:786-430-1271
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASTHMA & ALLERGY ASSOCIATES OF FL PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373589313Medicaid