Basic Information
| Provider Information | |||||||||
| NPI: | 1881669091 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAUL T FASS M.D., P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 729 | ||||||||
| Address2: | |||||||||
| City: | HALLANDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330080729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055036320 | ||||||||
| FaxNumber: | 3055036329 | ||||||||
| Practice Location | |||||||||
| Address1: | 2999 NE 191ST ST | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331803123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059339953 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2006 | ||||||||
| LastUpdateDate: | 03/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | FASS | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3059339953 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | ME15036 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy |
No ID Information.