Timothy Allen
Individual provider Active NPI Pharmacist · Leesburg, FL
NPI 1639844673 · NPPES record last updated Aug 11, 2021
Key facts
- NPI
- 1639844673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS22596 (FL)
- Practice address
- 215 N 3Rd St
Leesburg, FL 34748-5105 - Phone
- (352) 702-0079
- NPI assigned
- Aug 11, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS22596 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allen Investors and Pharmacy First Co LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS22596 | FL | Yes |
Addresses
Primary practice location
215 N 3Rd St
Leesburg, FL 34748-5105
Mailing address
PO Box 48795
Tampa, FL 33646-0124
Phone (813) 482-4257
Other providers in Leesburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.