Individual
ALLYSON CHRISTINA BAGENHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1905 CLINT MOORE RD STE 202, BOCA RATON, FL 33496-2660
(561) 757-5530
(561) 430-3590
Mailing address
1905 CLINT MOORE RD STE 202, BOCA RATON, FL 33496-2660
(561) 757-5530
(561) 430-3590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
051025
CT
207Q00000X
Family Medicine Physician
Primary
ME115466
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023279916
NPI
CT
Enumeration date
06/23/2008
Last updated
12/08/2021
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