Provider Demographics
NPI:1043414907
Name:TROWBRIDGE, ALLISON STAVINOHA (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:STAVINOHA
Last Name:TROWBRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 MOCKINGBIRD CT
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13610 BRUCE B DOWNS BLVD
Practice Address - Street 2:MEDEXPRESS NORTHSIDE
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4650
Practice Address - Country:US
Practice Address - Phone:813-977-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94959207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278389400Medicaid
FL93489OtherBCBS OF FLORIDA
FLAE761XMedicare PIN
FLAE761YMedicare PIN
FLP00477057Medicare PIN
FL278389400Medicaid