MEDICARE: DR. EVA VENEQUE ALLEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	24596	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114999174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVA VENEQUE ALLEN M.D.

Provider Business Mailing Address
First Line	:	1621 11TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-4703
Country	:	US
Telephone Number	:	205-930-9500
Fax Number	:	205-930-9503

Provider Business Practice Location Address
First Line	:	5401 E LAKE BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35217-3545
Country	:	US
Telephone Number	:	205-714-2451
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	04/29/2026

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