Active NPI
ENT and Allergy Associates of Florida, LLC
- Otolaryngology Physician
- West Palm Beach, FL
National Provider Identifier
1841527652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- OS10621
- Legal business name
- ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC
- Practice address
- 927 45TH St
Suite 101
West Palm Beach, FL 33407-2450 - Phone
- (561) 848-5579
- Fax
- (561) 848-9269
- NPI assigned
- Nov 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Todd S Bum, MHA, MBA, CMPE
- Title
- Chief Executive Officer
- Phone
- (561) 939-0177
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | OS10621 | Primary |
Addresses
Primary practice location
927 45TH St
Suite 101
West Palm Beach, FL 33407-2450
Mailing address
900 NW 13TH St
Suite 206
Boca Raton, FL 33486-2335
Phone (561) 338-3267
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001960300 | Medicaid | FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2209250 | ENT and Allergy Associates of Florida | Certificate of waiver | Jan 11, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Ear Nose Throat Assoc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Otolaryngology Physician
- Boca Raton, FL
- NPI 1548701840
Locations
927 45th St
Ste 101
Mangonia Park, FL 33407
Phone (561) 848-5579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649894400000",
"number": "1841527652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 NW 13TH ST",
"address_2": "SUITE 206",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334862335",
"telephone_number": "561-338-3267",
"fax_number": "561-391-4420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 45TH ST",
"address_2": "SUITE 101",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334072450",
"telephone_number": "561-848-5579",
"fax_number": "561-848-9269"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-16",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A",
"authorized_official_last_name": "BUM",
"authorized_official_first_name": "TODD",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "561-939-0177",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MHA, MBA, CMPE"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": "OS10621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001960300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.