Individual
ALISON M YOUNGTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3241 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2266
(863) 413-2620
(863) 499-2612
Mailing address
1290 GOLFVIEW AVE, ATTN: ACCOUNTS RECEIVABLE, BARTOW, FL 33830-6740
(863) 519-7900
(863) 519-7696
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35079456
OH
207R00000X
Internal Medicine Physician
Primary
ME103086
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004522400
—
FL
01
—
14L1N
BCBS
FL
05
—
2583100
—
OH
Enumeration date
09/28/2006
Last updated
02/12/2013
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