MEDICARE: ALLEN THERAPY SERVICES, PLLC

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	PT 19154	FL
2	261QM1300X	Multi-Specialty Clinic/Center
3	252Y00000X	Early Intervention Provider Agency
4	235Z00000X	Speech-Language Pathologist	SA5457	FL

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	:	1861656035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN THERAPY SERVICES, PLLC

Provider Business Mailing Address
First Line	:	660 SPANISH WELLS RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-8926
Country	:	US
Telephone Number	:	904-465-0178
Fax Number	:	904-770-5596

Provider Business Practice Location Address
First Line	:	2103 GILMORE ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-3211
Country	:	US
Telephone Number	:	904-465-0178
Fax Number	:	904-770-5596

Authorized Official
Title or Position	:	OWNER
Name	:	LORI M ALLEN
Credential	:	SLP
Telephone Number	:	904-465-0178

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	10/06/2025

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Directions to “ALLEN THERAPY SERVICES, PLLC ” Practice Location

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