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Organization

ALLISON WYMAN MD LLC

Active
Other names
Allison Wyman MD LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MARIA OTERO CREDENTIALING (CREDENTIALING SPECIALIST)
(727) 499-0351
Entity
Organization

Contact information

Practice address
2919 W SWANN AVE STE 404, TAMPA, FL 33609-4052
(813) 773-0579
Mailing address
2410 NORTHSIDE DR, CLEARWATER, FL 33761-2236
(727) 499-0351
(727) 781-3312

Taxonomy

Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary

Other

Enumeration date
12/15/2022
Last updated
10/21/2024
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