Provider Demographics
NPI:1952978124
Name:BREATHE FREE SINUS & ALLERGY CENTERS OF FLORIDA LLC
Entity Type:Organization
Organization Name:BREATHE FREE SINUS & ALLERGY CENTERS OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-210-5491
Mailing Address - Street 1:4601 SPANISH TRL
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-5039
Mailing Address - Country:US
Mailing Address - Phone:805-210-5491
Mailing Address - Fax:805-842-2648
Practice Address - Street 1:4601 SPANISH TRL
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5039
Practice Address - Country:US
Practice Address - Phone:850-990-9407
Practice Address - Fax:805-842-2648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty