Individual
DR. REGINALD A ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 MAGNOLIA AVE SW, WINTER HAVEN, FL 33880
(863) 293-6375
(863) 293-8877
Mailing address
PO BOX 90758, LAKELAND, FL 33804-0758
(407) 566-9899
(407) 566-9893
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036069997
IL
208800000X
Urology Physician
Primary
ME57508
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069997
—
IL
05
—
277900500
—
FL
Enumeration date
06/24/2005
Last updated
06/20/2014
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