Individual
ALLEN W ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 5TH ST S, ST PETERSBURG, FL 33701
(727) 767-3636
(727) 767-3638
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME8466
FL
2080P0205X
Pediatric Endocrinology Physician
Primary
ME8466
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053020400
—
FL
01
—
52839
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/09/2006
Last updated
06/01/2018
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