Individual
LIA M ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(866) 762-1743
(727) 816-1222
Mailing address
2995 DREW ST, CLEARWATER, FL 33759-3012
(727) 281-9065
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
457
FL
367H00000X
Anesthesiologist Assistant
Primary
75000148A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101684989
ANTHEM PTAN
IN
01
—
264430I59
MEDICARE PTAN
IN
01
—
Q00699782
RAILROAD PTAN
IN
Enumeration date
08/14/2018
Last updated
07/30/2025
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