=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407996267
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLEN HEALTHCARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1801 LEE RD SUITE 130
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32789-2162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-629-1100
-----------------------------------------------------
Fax | 407-629-4926
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1801 LEE RD SUITE 130
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32789-2162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-629-1100
-----------------------------------------------------
Fax | 407-629-4926
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. DENNIS R ALLEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-629-1100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 20361096
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------