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General NPI Number Information
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NPI Number | 1225244296
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Entity Type | Individual
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Provider Name | MICHAEL F INESTA-ALLISON MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1401 S 31ST ST FL 2
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City | PHILADELPHIA
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State | PA
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Zip | 19146-3506
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Country | US
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Telephone | 215-925-2400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6471
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City | MAYAGUEZ
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State | PR
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Zip | 00681-6471
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Country | US
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Telephone | 787-550-4519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME98958
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 13748
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD482159
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License Number State | PA
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