Plant City Allergy, P.a.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

ME81615 Issued in FL

Legal business name

PLANT CITY ALLERGY, P.A.

Practice address

106 Southern Oaks Dr
Plant City, FL 33563-1446

Phone

(813) 752-8595

NPI assigned

Jan 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David E. Provencher Jr., M.D.

Title

Owner-Physician

Phone

(813) 752-8595

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083760748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2156",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335642156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SOUTHERN OAKS DR",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335631446",
            "telephone_number": "813-752-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANT CITY ALLERGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROVENCHER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER-PHYSICIAN",
        "authorized_official_telephone_number": "813-752-8595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME81615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physiotherapy Associates Inc (Physiotherapy Associates-Plant City)
• Jennifer Piasecki
• Carmen Rymer Piccolo, LCSW
• Joy Angel Pierce
• Pinnacle Health Group PA
• Plant City Cardiology Associates LLC
• Plant City Internal Medicine Specialists, P.a.
• Plant City Medical Group, LLC
• Plant City Pediatrics, PA
• Plant City Primary Care Associates

• Allergy & Immunology Physician in Plant City, FL
• Providers in Plant City, FL by specialty
• Allergy & Immunology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.