MEDICARE: DR. PHILIP ALLEN PT, DPT

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	225100000X	Physical Therapist	PT39725	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01317258	OTHER	DE	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1831169689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP ALLEN PT, DPT

Provider Business Mailing Address
First Line	:	2230 FIRESTONE WAY
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-4308
Country	:	US
Telephone Number	:	302-245-4792
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 FIRESTONE WAY
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-4308
Country	:	US
Telephone Number	:	302-245-4792
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	03/28/2025

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