MEDICARE: MR. JOHN WARNER ALLER

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	253J00000X	Foster Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528233863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN WARNER ALLER

Provider Business Mailing Address
First Line	:	2937 S ATLANTIC AVE
Second Line	:	APT 508
City	:	DAYTONA BEACH SHORES
State	:	FL
Zip	:	32118-6045
Country	:	US
Telephone Number	:	386-767-7731
Fax Number	:

Provider Business Practice Location Address
First Line	:	2937 S ATLANTIC AVE
Second Line	:	APT 508
City	:	DAYTONA BEACH SHORES
State	:	FL
Zip	:	32118-6045
Country	:	US
Telephone Number	:	386-767-7731
Fax Number	:

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

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	04/28/2008

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Directions to “ MR. JOHN WARNER ALLER ” Practice Location

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