Provider Demographics
NPI:1760904866
Name:DEMANY, ALLISON LEE (DMSC, PA-C)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEE
Last Name:DEMANY
Suffix:
Gender:F
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LEE
Other - Last Name:MERGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 W FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3413
Mailing Address - Country:US
Mailing Address - Phone:888-330-2532
Mailing Address - Fax:813-264-0098
Practice Address - Street 1:508 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3413
Practice Address - Country:US
Practice Address - Phone:888-330-2532
Practice Address - Fax:813-264-0098
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059114363A00000X
FLPA9112789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1117211OtherNCCPA