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General NPI Number Information
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NPI Number | 1770235376
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Entity Type | Organization
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Legal Business Name | ALLEGIANT HEALTH & ASSOCIATES
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 130 BATES AVE SW STE 111
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City | WINTER HAVEN
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State | FL
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Zip | 33880-2920
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Country | US
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Telephone | 863-268-4626
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Fax | 866-825-5809
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Provider Business Mailing Address
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Address Line | PO BOX 92923
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City | LAKELAND
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State | FL
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Zip | 33804-2923
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Country | US
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Telephone | 863-268-4626
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Fax | 866-825-5809
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Authorized Official
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Title or Position | PRACTICE MANGER
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Name | EBONY MONIQUE ROLLINS
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Credential | APRN
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Telephone | 863-268-4626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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