Provider Demographics
NPI:1477812824
Name:FERRARA, ALLISON POIMBOEUF (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:POIMBOEUF
Last Name:FERRARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:CAMILLE
Other - Last Name:POIMBOEUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:806 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6625
Mailing Address - Country:US
Mailing Address - Phone:407-483-3376
Mailing Address - Fax:407-279-4005
Practice Address - Street 1:806 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6625
Practice Address - Country:US
Practice Address - Phone:407-483-3376
Practice Address - Fax:407-279-4005
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA305415207R00000X
AL33459207R00000X
390200000X
FLME135995207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME135995OtherLICENSE