Healthcare Provider Details

I. General information

NPI: 1174898266
Provider Name (Legal Business Name): ALLGEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 N ORANGE AVE
ORLANDO FL
32804-6415
US

IV. Provider business mailing address

1810 N ORANGE AVE
ORLANDO FL
32804-6415
US

V. Phone/Fax

Practice location:
  • Phone: 407-420-7900
  • Fax: 407-440-2877
Mailing address:
  • Phone: 407-420-7900
  • Fax: 407-440-2877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH25997
License Number StateFL

VIII. Authorized Official

Name: UMESH PATEL
Title or Position: MMGR
Credential:
Phone: 407-379-1000