Organization
ENT AND ALLERGY ASSOCIATES OF FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LIBUSE LOPEZ (CBO CREDENTIALING)
(561) 338-3267
Entity
Organization
Contact information
Practice address
6421 CONGRESS AVE STE 113, BOCA RATON, FL 33487-2858
(561) 338-3267
(561) 391-4420
Mailing address
900 NW 13TH ST, SUITE 206, BOCA RATON, FL 33486-2350
(561) 391-3333
(561) 391-5618
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119315300
—
FL
01
—
21513
BLUE CROSS FLORIDA GROUP
FL
Enumeration date
05/15/2006
Last updated
12/04/2024
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