Anti-Aging & Wellness Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS5170 Issued in FL

Legal business name

ANTI-AGING & WELLNESS MEDICAL CENTER

Practice address

1502 S Macdill Ave
Tampa, FL 33629-5214

Phone

(813) 253-3223

Fax

(813) 251-4407

NPI assigned

Sep 24, 2007

Last updated

Jun 21, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jean M Allen, D.O,

Title

Owner

Phone

(813) 253-3223

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1548456486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S MACDILL AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295214",
            "telephone_number": "813-253-3223",
            "fax_number": "813-251-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S MACDILL AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295214",
            "telephone_number": "813-253-3223",
            "fax_number": "813-251-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTI-AGING & WELLNESS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-253-3223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O,"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Anthony
• Kimberly Anthony
• Stefan Santo Anthony, DO
• Teresa Irene Anthony, MA, CCC-SLP
• Sheryl Lynn Anthos, MD
• Tori Elizabeth Antley
• Chavara Chacko Antochen, RRT
• Adriel Mylitta Antoine-Bland
• John Eugene Antoine, M.D.
• Marsha Antoine, M.D.

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.