Allergy Sinus & Asthma Center of Leesburg Inc
Organization Active NPI Specialist · Lady Lake, FL
NPI 1992718290 · NPPES record last updated Apr 1, 2015
Key facts
- NPI
- 1992718290
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- ALLERGY SINUS & ASTHMA CENTER OF LEESBURG INC
- Practice address
- 309 Lagrande Blvd
Lady Lake, FL 32159-2386 - Phone
- (352) 750-1999
- Fax
- (352) 750-1998
- NPI assigned
- Aug 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Judy Ann Naumann
- Title
- Office Manager
- Phone
- (352) 750-1999
Practitioners 7
-
Kevin Patrick Noon, ARNP
-
Martin T Potrawski, ARNP
-
Jay Pravda, M.D.
-
Sylvia Fae Wallace, APRN, BC
-
Paul S Austin, MD
-
Tamara L Rhodes, RN, MSN, ARNP-BC
National Provider Directory
Locations
309 Lagrande Blvd
The Villages, FL 32159
Phone (352) 750-1999
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
309 Lagrande Blvd
Lady Lake, FL 32159-2386
Mailing address
PO Box 1804
Lady Lake, FL 32158-1804
Phone (352) 750-1999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y8614 | Other | FL | BC/BS |
| 00243 | Other | FL | BS/BC GROUP # |
| P00141885 | Other | FL | RAILROAD MEDICARE |
Other providers in Lady Lake, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.