Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | ME110242 | FL |
N | 2080P0208X | Pediatric Infectious Diseases | 0101057845 | VA |
N | 2080P0208X | Pediatric Infectious Diseases | 2004017086 | MO |
NPI | 1053380493 |
---|---|
Provider Name | Dr. Thomas J. Allen |
First Address | Jacksonville, FL 32247-5720 |
Second Address | Orlando, FL 32806-2946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 16/03/2012 |