Active NPI
Phyllis L Allen, HAIR RESTORATION SPE
- Prosthetics Case Management
- Orlando, FL
National Provider Identifier
1417478447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- CL0227470
- Practice address
- 5759 Edgewater Dr
Orlando, FL 32810-5258 - Phone
- (407) 733-0705
- Fax
- (407) 521-1595
- NPI assigned
- Jun 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | CL0227470 | FL | Primary |
Addresses
Primary practice location
5759 Edgewater Dr
Orlando, FL 32810-5258
Mailing address
5759 Edgewater Dr
Orlando, FL 32810-5258
Phone (407) 733-0705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CL0227470 | FL | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417478447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5759 EDGEWATER DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328105258",
"telephone_number": "407-733-0705",
"fax_number": "407-521-1595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5759 EDGEWATER DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328105258",
"telephone_number": "407-733-0705",
"fax_number": "407-521-1595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "PHYLLIS",
"middle_name": "L",
"credential": "HAIR RESTORATION SPE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-29",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "FL",
"license": "CL0227470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.