Individual
MRS. MARTHA L ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PN1270731
FL
347C00000X
Private Vehicle
PN1270731
FL
385H00000X
Respite Care
PN1270731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691001796
—
FL
Enumeration date
01/07/2011
Last updated
01/07/2011
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