Individual
ALISON HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 257-0558
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 257-0558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116050
FL
363AM0700X
Medical Physician Assistant
PA00818
RI
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115340000
—
FL
Enumeration date
06/15/2015
Last updated
11/20/2024
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