# ALLIED HEALTH PROVIDER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528557394
- **Authorized official:** DIANA MARTINEZ PA-C (OWNER / PROVIDER)
- **Authorized official phone:** (305) 989-7291

## Contact information

- **Practice address:** 1625 NE 3RD CT, FORT LAUDERDALE, FL 33301-3808
- **Practice address phone:** (305) 989-7291
- **Mailing address:** 701 THREE ISLANDS BLVD STE 118, HALLANDALE BEACH, FL 33009-2822
- **Mailing address phone:** (305) 989-7291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA9105777 | FL | Yes |

## Other

- **Enumeration date:** 05/07/2018
- **Last updated:** 05/07/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1811266216 | INDIVIDUAL NPI NUMBER | — |