Healthcare Provider Details

I. General information

NPI: 1508923343
Provider Name (Legal Business Name): ALLEN LINDSAY PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 11/17/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COREY AVE
ST PETE BEACH FL
33706-1814
US

IV. Provider business mailing address

100 COREY AVE
ST PETE BEACH FL
33706-1814
US

V. Phone/Fax

Practice location:
  • Phone: 727-341-1402
  • Fax: 727-376-6578
Mailing address:
  • Phone: 727-341-1402
  • Fax: 727-376-6784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY5315
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: