Provider Demographics
NPI:1477723674
Name:ALLENBY & ASSOCIATES DERMATOLOGY SPECIALIST INC
Entity Type:Organization
Organization Name:ALLENBY & ASSOCIATES DERMATOLOGY SPECIALIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLENBY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-499-0299
Mailing Address - Street 1:6290 LINTON BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6409
Mailing Address - Country:US
Mailing Address - Phone:561-499-0299
Mailing Address - Fax:561-499-4994
Practice Address - Street 1:6290 LINTON BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6409
Practice Address - Country:US
Practice Address - Phone:561-499-0299
Practice Address - Fax:561-499-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0006340174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7499OtherMEDICARE GROUP NUMBER
FLF54807Medicare UPIN