Provider Demographics
NPI:1538146105
Name:ALLEN, BARBARA (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 SUNFOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6327
Mailing Address - Country:US
Mailing Address - Phone:727-824-0780
Mailing Address - Fax:813-514-8891
Practice Address - Street 1:5130 SUNFOREST DR STE 300
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6327
Practice Address - Country:US
Practice Address - Phone:727-824-0780
Practice Address - Fax:813-514-8891
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43363207Q00000X
FLME125308207Q00000X
TXN1248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198520201Medicaid
MN363640200Medicaid
IA714139Medicaid
FL018414500Medicaid
MN160675Medicaid
TXTIN PLUS 023OtherTRICARE
TXTIN PLUS 028OtherTRICARE
MN14370OtherAVERA
MN160675Medicaid
TX198520201Medicaid
IA714139Medicaid
TXTIN PLUS 066OtherTRICARE
MN01-22108OtherMEDICA
MN272P9ALOtherBLUE CROSS BLUE SHEILD
MN363640200Medicaid
MNMH9041026909OtherPREFERREDONE
TXTIN PLUS 001OtherTRICARE
MN236497OtherMIDLAND'S CHOICE
TXTIN PLUS 007OtherTRICARE
MN236497OtherMIDLAND'S CHOICE
TXTIN PLUS 023OtherTRICARE
IA714139Medicaid
IA714139Medicaid