Provider Demographics
NPI:1467137158
Name:EVERETT, ALLEN WINDELL SR (APD PROVIDER)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:WINDELL
Last Name:EVERETT
Suffix:SR
Gender:M
Credentials:APD PROVIDER
Other - Prefix:MRS
Other - First Name:JULIET
Other - Middle Name:A
Other - Last Name:EVERETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CALMINGHEALTH
Mailing Address - Street 1:6239 ASHBURY PALMS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-5113
Mailing Address - Country:US
Mailing Address - Phone:813-489-4580
Mailing Address - Fax:813-489-4580
Practice Address - Street 1:6239 ASHBURY PALMS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-5113
Practice Address - Country:US
Practice Address - Phone:813-489-4580
Practice Address - Fax:813-489-4580
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child