Provider Demographics
NPI:1083960033
Name:SAMMONS, ALLISON BRUNER (DNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:BRUNER
Last Name:SAMMONS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 30
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3426
Mailing Address - Country:US
Mailing Address - Phone:561-602-5599
Mailing Address - Fax:
Practice Address - Street 1:7050 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 30
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3426
Practice Address - Country:US
Practice Address - Phone:561-353-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9247229363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006434100Medicaid
FLGK845ZMedicare PIN