MEDICARE: MS. ROSEMARIE JOYCE ALLEN AP

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	225200000X	Physical Therapy Assistant	PTA9717	FL
2	171100000X	Acupuncturist	AP2263	FL

General Provider Information

NPI Number	:	1235388869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSEMARIE JOYCE ALLEN AP

Provider Business Mailing Address
First Line	:	1519 FLAGLER AVE,
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207
Country	:	US
Telephone Number	:	904-327-0457
Fax Number	:	904-645-6540

Provider Business Practice Location Address
First Line	:	2008 RIVERSIDE AVENUE
Second Line	:	SUITE 300
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204
Country	:	US
Telephone Number	:	904-327-0457
Fax Number	:	904-645-6540

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

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	08/07/2018

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