Provider Demographics
NPI:1700818275
Name:GODWIN-KAROLAK, ALLISON MAUREEN (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MAUREEN
Last Name:GODWIN-KAROLAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 HIGHLAND PARK CIR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5305
Mailing Address - Country:US
Mailing Address - Phone:727-483-8376
Mailing Address - Fax:
Practice Address - Street 1:4809 N ARMENIA AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1447
Practice Address - Country:US
Practice Address - Phone:727-483-8376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08097700207Q00000X
FLOS10807207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine