Asthma Allergy & Sinus Clinic PA

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

ME51694 Issued in FL

Legal business name

ASTHMA ALLERGY & SINUS CLINIC PA

Practice address

353 N Clyde Morris Blvd
Daytona Beach, FL 32114-2732

Phone

(386) 252-6622

NPI assigned

Mar 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Roberto Di Nicolo, MD

Title

Director

Phone

(386) 252-6622

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1255460507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142732",
            "telephone_number": "386-252-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142732",
            "telephone_number": "386-252-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTHMA ALLERGY & SINUS CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-04",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "DI NICOLO",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "386-252-6622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME51694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257346600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Daytona Beach, FL
• Providers in Daytona Beach, 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 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.