Provider Demographics
NPI:1003864695
Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES OF CENTRAL FLORIDA
Entity type:Organization
Organization Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-678-4040
Mailing Address - Street 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2228
Mailing Address - Country:US
Mailing Address - Phone:407-678-4040
Mailing Address - Fax:407-678-6935
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 215
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2228
Practice Address - Country:US
Practice Address - Phone:407-678-4040
Practice Address - Fax:407-678-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001571000Medicaid
FL1003864695Medicare Oscar/Certification