Individual
MR. ALOYSIUS T BISONG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
808 HIGHWAY 466, LADY LAKE, FL 32159
(352) 751-0040
(352) 751-2825
Mailing address
P O BOZ 850001 DEPT # 8015, ORLANDO, FL 32885-8015
(352) 861-0440
(352) 861-1869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9105417
FL
363A00000X
Physician Assistant
Primary
PA9105417
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9105417
MEDICAL LICENSE
FL
Enumeration date
05/01/2008
Last updated
08/07/2023
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