Provider Demographics
NPI:1689986804
Name:ALLEN, BRIANO (PHARMD, DDS, MS)
Entity Type:Individual
Prefix:
First Name:BRIANO
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PHARMD, DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 CAPITAL MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4411
Mailing Address - Country:US
Mailing Address - Phone:850-877-0536
Mailing Address - Fax:850-877-5808
Practice Address - Street 1:3101 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4411
Practice Address - Country:US
Practice Address - Phone:850-877-0536
Practice Address - Fax:850-877-5808
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN199731223X0400X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics