Healthcare Provider Details

I. General information

NPI: 1417307216
Provider Name (Legal Business Name): ALLISON GOPAUL HALSTEAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLISON GOPAUL MD

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST
ORLANDO FL
32806-2031
US

IV. Provider business mailing address

83 W MILLER ST
ORLANDO FL
32806-2031
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-9792
  • Fax: 407-389-5312
Mailing address:
  • Phone: 321-843-9792
  • Fax: 407-389-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG140000907600
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME144835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: