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General NPI Number Information
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NPI Number | 1316598717
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Entity Type | Individual
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Provider Name | CRYSTAL ALLEN
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Gender | Female
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 4700 NW 2ND AVE STE 101
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City | BOCA RATON
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State | FL
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Zip | 33431-4158
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Country | US
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Telephone | 561-563-6262
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Fax | 561-223-2974
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Provider Business Mailing Address
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Address Line | 1530 SW 109TH AVE APT 207
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-5544
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Country | US
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Telephone | 786-707-5166
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11004479
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License Number State | FL
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