Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME109885 | FL |
Y | 208600000X | Surgeon | ME109885 | FL |
NPI | 1003132887 |
---|---|
Provider Name | Dr. Nathan D Allison |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32940-2239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 01/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003727900 | (05) | FL |
FF615Y | MEDICARE (01) | FL |