Provider Demographics
NPI:1992001473
Name:ALLERGY, ASTHMA & SINUS ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA & SINUS ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-717-1919
Mailing Address - Street 1:2510 E OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1601
Mailing Address - Country:US
Mailing Address - Phone:954-717-1919
Mailing Address - Fax:954-717-2528
Practice Address - Street 1:2510 E OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1601
Practice Address - Country:US
Practice Address - Phone:954-717-1919
Practice Address - Fax:954-717-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92264207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16010OtherBCBS
FL003737500Medicaid
FL003737500Medicaid