Healthcare Provider Details

I. General information

NPI: 1598016701
Provider Name (Legal Business Name): ALLISON A GARSTECKI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 GREENO RD N
FAIRHOPE AL
36532-2914
US

IV. Provider business mailing address

4960 SW 72ND AVE STE 405
MIAMI FL
33155-5506
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-2228
  • Fax: 251-625-2112
Mailing address:
  • Phone: 469-458-9222
  • Fax: 443-595-6960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA855
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.855
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00173
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: