Provider Demographics
NPI:1447345251
Name:LENOIR, ALLEN ADRED (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:ADRED
Last Name:LENOIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 561823
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-1823
Mailing Address - Country:US
Mailing Address - Phone:305-662-9999
Mailing Address - Fax:305-271-1094
Practice Address - Street 1:2506 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6013
Practice Address - Country:US
Practice Address - Phone:305-662-9999
Practice Address - Fax:305-271-1094
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51574174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052154000Medicaid
FL25141Medicare ID - Type Unspecified