Organization
ASTHMA ALLERGY & SINUS CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTO DI NICOLO MD (DIRECTOR)
(386) 252-6622
Entity
Organization
Contact information
Practice address
353 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2732
(386) 252-6622
Mailing address
353 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2732
(386) 252-6622
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME51694
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257346600
—
FL
Enumeration date
03/04/2007
Last updated
08/24/2010
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