# PLANT CITY ALLERGY, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083760748
- **Authorized official:** DR. DAVID E. PROVENCHER JR. M.D. (OWNER-PHYSICIAN)
- **Authorized official phone:** (813) 752-8595

## Contact information

- **Practice address:** 106 SOUTHERN OAKS DR, PLANT CITY, FL 33563-1446
- **Practice address phone:** (813) 752-8595
- **Mailing address:** PO BOX 2156, PLANT CITY, FL 33564-2156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | ME81615 | FL | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 08/22/2020