OrganizationActive
All Seasons Allergy and Asthma Center, P.A.
NPI 1578618104 · Allergy & Immunology Physician · Fort Walton Beach, FL
Provider details
- NPI number
- 1578618104
- Entity type
- Organization
- Primary specialty
- Allergy & Immunology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Justin Clark, Director(850) 862-3020
- License
- OS9224 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
362 Beal Pkwy Nw Ste 105
Fort Walton Beach, FL 32548-3926
Phone: (850) 862-3020
Fax: (850) 862-1363
Approximate (ZIP-level) locationGet directions
Mailing address
362 Beal Pkwy Nw Ste 105
Fort Walton Beach, FL 32548-3926
Registry dates
- Enumerated
- 2007-01-24
- Last updated
- 2017-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.