MEDICARE: CORINA ALLEN

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1538004718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINA ALLEN

Provider Business Mailing Address
First Line	:	324 BROOKEDGE ST NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3059
Country	:	US
Telephone Number	:	607-760-3272
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 BROOKEDGE ST NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3059
Country	:	US
Telephone Number	:	607-760-3272
Fax Number	:

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

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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Directions to “ CORINA ALLEN ” Practice Location

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