Provider Demographics
NPI:1356355200
Name:MARK ALAGNA MD PA
Entity type:Organization
Organization Name:MARK ALAGNA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ALAGNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-819-1651
Mailing Address - Street 1:13906 LAKESHORE BLVD
Mailing Address - Street 2:SUITE #320
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-1487
Mailing Address - Country:US
Mailing Address - Phone:727-819-1651
Mailing Address - Fax:727-819-1653
Practice Address - Street 1:13906 LAKESHORE BLVD
Practice Address - Street 2:SUITE #320
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1487
Practice Address - Country:US
Practice Address - Phone:727-819-1651
Practice Address - Fax:727-819-1653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39687208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D56634Medicare UPIN
FL5763170001Medicare NSC