Healthcare Provider Details

I. General information

NPI: 1366355331
Provider Name (Legal Business Name): ALLISON EGGERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6595 S FLORIDA AVE
LAKELAND FL
33813-3316
US

IV. Provider business mailing address

4722 SILKRUN CT
PLANT CITY FL
33566-1209
US

V. Phone/Fax

Practice location:
  • Phone: 863-593-7804
  • Fax:
Mailing address:
  • Phone: 727-366-7436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11051131
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: