Tallahassee Allergy, Asthma & Immunology, LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

ME82516 Issued in FL

Legal business name

TALLAHASSEE ALLERGY, ASTHMA & IMMUNOLOGY, LLC

Practice address

2619 Centennial Blvd Ste 103
Tallahassee, FL 32308-0590

Phone

(850) 656-7720

Fax

(850) 656-7729

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Brian Guy Wilson, M.D.NPI 1760433247

Title

Owner

Phone

(850) 656-7720

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Guy Wilson, M.D.

  • Allergy Physician
  • Tallahassee, FL
  • NPI 1760433247
  Medicare reassignment Care Compare group NPD Authorized official
• Narlito V Cruz, M.D.

  • Allergy & Immunology Physician
  • Tallahassee, FL
  • NPI 1467511816

  GA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1285648683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13058",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173058",
            "telephone_number": "850-656-7720",
            "fax_number": "850-656-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 CENTENNIAL BLVD STE 103",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080590",
            "telephone_number": "850-656-7720",
            "fax_number": "850-656-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHASSEE ALLERGY, ASTHMA & IMMUNOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-656-7720",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME82516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2622203",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Tallahassee, FL
• Providers in Tallahassee, 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 May 2, 2011; 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.