Provider Demographics
NPI:1982746863
Name:ALLEN, DAVID MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5141 DEER PARK DR # 1C
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-7013
Mailing Address - Country:US
Mailing Address - Phone:727-847-2406
Mailing Address - Fax:727-841-0567
Practice Address - Street 1:5141 DEER PARK DR STE 1C
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-7013
Practice Address - Country:US
Practice Address - Phone:727-847-2406
Practice Address - Fax:727-841-0567
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3000213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU91442Medicare UPIN
FL4009620001Medicare NSC
FLE7889Medicare PIN