Provider Demographics
NPI:1720082753
Name:ALLERGY ASSOCIATES OF THE PALM BEACHES, P.A.
Entity Type:Organization
Organization Name:ALLERGY ASSOCIATES OF THE PALM BEACHES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RODGER
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-626-2006
Mailing Address - Street 1:840 US HIGHWAY 1
Mailing Address - Street 2:SUITE 235
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3830
Mailing Address - Country:US
Mailing Address - Phone:561-626-2006
Mailing Address - Fax:561-624-9718
Practice Address - Street 1:840 US HWY #1
Practice Address - Street 2:SUITE 235
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-626-2006
Practice Address - Fax:561-624-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34195207K00000X
FL058623207K00000X
FLARNP2029482207K00000X
FLARNP2993372207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7113OtherMEDICARE
FLK0216OtherMEDICARE PTAN
FLE7878ZOtherMEDICARE
FLH67966OtherUPIN
FLS51831OtherUPIN
FLK0216OtherMEDICARE PTAN