Organization
FAMILY ALLERGY & ASTHMA CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LALLAINE VILLEGAS (ANCO)
(904) 636-9100
Entity
Organization
Contact information
Practice address
4123 UNIVERSITY BLVD S, SUITE B, JACKSONVILLE, FL 32216-4371
(904) 636-9102
(904) 636-9102
Mailing address
4123 UNIVERSITY BLVD S, SUITE B, JACKSONVILLE, FL 32216-4371
(904) 636-9102
(904) 636-9102
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AG327
MEDICARE PTAN
—
Enumeration date
12/14/2006
Last updated
04/10/2025
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