Provider Demographics
NPI:1275592842
Name:BAUMAL, ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:BAUMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4970 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5300
Mailing Address - Country:US
Mailing Address - Phone:954-977-0270
Mailing Address - Fax:954-977-6824
Practice Address - Street 1:151 SOUTHHALL LN
Practice Address - Street 2:STE 300
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7176
Practice Address - Country:US
Practice Address - Phone:407-875-2080
Practice Address - Fax:407-650-3455
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME12514207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268986300Medicaid
FL268986300Medicaid
FL90976YMedicare PIN