MEDICARE: DR. THOMAS J. ALLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0208X	Pediatric Infectious Diseases Physician	0101057845	VA
2	2083A0100X	Aerospace Medicine Physician	0101057845	VA
3	171000000X	Military Health Care Provider	0101057845	VA
4	2080P0208X	Pediatric Infectious Diseases Physician	ME110242	FL
5	2080P0208X	Pediatric Infectious Diseases Physician	2004017086	MO
6	286500000X	Military Hospital	0101057845	VA
7	208D00000X	General Practice Physician	0101057845	VA

General Provider Information

NPI Number	:	1053380493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS J. ALLEN MD

Provider Business Mailing Address
First Line	:	P.O. BOX 5720
Second Line	:	PROVIDER ENROLLMENT DEPARTMENT
City	:	JACKSONVILLE
State	:	FL
Zip	:	32247-5720
Country	:	US
Telephone Number	:	302-651-5985
Fax Number	:	407-650-7578

Provider Business Practice Location Address
First Line	:	1717 S. ORANGE AVE. SUITE 100
Second Line	:	NEMOURS CHILDRENS CLINIC ORLANDO
City	:	ORLANDO
State	:	FL
Zip	:	32806-2946
Country	:	US
Telephone Number	:	407-650-7715
Fax Number	:	407-650-7124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	09/25/2025

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