Provider Demographics
NPI:1700895042
Name:ALLEN, BRENDA O (RRT)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:O
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11428 SW 109TH RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3148
Mailing Address - Country:US
Mailing Address - Phone:305-595-8232
Mailing Address - Fax:305-598-1073
Practice Address - Street 1:5920 SW 68TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3524
Practice Address - Country:US
Practice Address - Phone:305-595-8232
Practice Address - Fax:305-595-8232
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT1390227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884697900Medicaid