Provider Demographics
NPI:1891931689
Name:ALLERGY & ARTHRITIS TREATMENT CENTERS LLC
Entity Type:Organization
Organization Name:ALLERGY & ARTHRITIS TREATMENT CENTERS LLC
Other - Org Name:LESLIE TAR, MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:941-625-3402
Mailing Address - Street 1:22226 WESTCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-9202
Mailing Address - Country:US
Mailing Address - Phone:941-625-3402
Mailing Address - Fax:
Practice Address - Street 1:22226 WESTCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9202
Practice Address - Country:US
Practice Address - Phone:941-625-3402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-28
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3658046207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty