Provider Demographics
NPI:1427161041
Name:FINE, ALLAN DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:DAVID
Last Name:FINE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 STARKEY RD
Mailing Address - Street 2:#2401
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-5445
Mailing Address - Country:US
Mailing Address - Phone:727-462-9797
Mailing Address - Fax:
Practice Address - Street 1:801 W BAY DR STE 337
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3269
Practice Address - Country:US
Practice Address - Phone:727-458-0855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2017-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4961103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical