1326327768 NPI number — MRS. ALLISON MARIE RIEGELMAN FNP-BC

Table of content: MRS. ALLISON MARIE RIEGELMAN FNP-BC (NPI 1326327768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326327768 NPI number — MRS. ALLISON MARIE RIEGELMAN FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIEGELMAN
Provider First Name:
ALLISON
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUECK
Provider Other First Name:
ALLISON
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326327768
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2580 METROCENTRE BLVD
Provider Second Line Business Mailing Address:
STE 3
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33407-3100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-594-1840
Provider Business Mailing Address Fax Number:
800-906-3055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2580 METROCENTRE BLVD
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33407-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-594-1840
Provider Business Practice Location Address Fax Number:
800-906-3055
Provider Enumeration Date:
08/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APRN9170057 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010591400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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