Basic Information
| Provider Information | |||||||||
| NPI: | 1730193251 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | ALISON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12479 TELECOM DR | ||||||||
| Address2: | |||||||||
| City: | TEMPLE TERRACE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336370913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139724199 | ||||||||
| FaxNumber: | 8139725753 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 E FLETCHER AVE | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336134613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139716000 | ||||||||
| FaxNumber: | 8139725753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 09/09/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME74810 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | K6711 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | 207PP0204X | ME74810 | FL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 10026584 | 05 | TX | MEDICAID | 276279 | 01 | TX | SCOTT & WHITE | OTHER | 82942Y | 01 | TX | BCBS | OTHER | 7240025 | 01 | TX | AETNA | OTHER | 003230700 | 05 | FL | MEDICAID | 14C19 | 01 | FL | BCBS OF FLORIDA | OTHER | 092504201 | 05 | TX | MEDICAID |