Provider Demographics
NPI:1043091994
Name:ALLEN, DYLAN MICHAEL (MSPH, CGC)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:MICHAEL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MSPH, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 OASIS MEWS DR UNIT 6403
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-8462
Mailing Address - Country:US
Mailing Address - Phone:727-642-6609
Mailing Address - Fax:
Practice Address - Street 1:6535 NEMOURS PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7884
Practice Address - Country:US
Practice Address - Phone:407-650-7715
Practice Address - Fax:407-650-7133
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS