MEDICARE: ALLEN INVESTORS AND PAIN CLINIC CO, LLC

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	305S00000X	Point of Service		FL

General Provider Information

NPI Number	:	1558596650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN INVESTORS AND PAIN CLINIC CO, LLC

Provider Business Mailing Address
First Line	:	IN N OUT PAIN CLINIC
Second Line	:	7229 N. DALE MABRY HWY #8
City	:	TAMPA
State	:	FL
Zip	:	33614-2699
Country	:	US
Telephone Number	:	813-374-2416
Fax Number	:	813-374-2417

Provider Business Practice Location Address
First Line	:	7229 N DALE MABRY HWY
Second Line	:	SUITE #8
City	:	TAMPA
State	:	FL
Zip	:	33614-2699
Country	:	US
Telephone Number	:	813-374-2416
Fax Number	:	813-374-2417

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. TIMOTHY ALLEN
Credential	:	RPH.
Telephone Number	:	813-374-2416

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	05/19/2009

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