Provider Demographics
NPI:1558596650
Name:ALLEN INVESTORS AND PAIN CLINIC CO, LLC
Entity Type:Organization
Organization Name:ALLEN INVESTORS AND PAIN CLINIC CO, LLC
Other - Org Name:IN N OUT PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-374-2416
Mailing Address - Street 1:IN N OUT PAIN CLINIC
Mailing Address - Street 2:7229 N. DALE MABRY HWY #8
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2699
Mailing Address - Country:US
Mailing Address - Phone:813-374-2416
Mailing Address - Fax:813-374-2417
Practice Address - Street 1:7229 N DALE MABRY HWY
Practice Address - Street 2:SUITE #8
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2699
Practice Address - Country:US
Practice Address - Phone:813-374-2416
Practice Address - Fax:813-374-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service