Healthcare Provider Details

I. General information

NPI: 1548755408
Provider Name (Legal Business Name): DANIEL JAMES ALLEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2018
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 SW 17TH ST STE 200
OCALA FL
34471-1227
US

IV. Provider business mailing address

5980 SW 117TH LANE RD
OCALA FL
34476-8685
US

V. Phone/Fax

Practice location:
  • Phone: 352-877-3360
  • Fax: 866-552-4890
Mailing address:
  • Phone: 614-439-6437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9111366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: