Basic Information
| Provider Information | |||||||||
| NPI: | 1336374529 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMMAN | ||||||||
| FirstName: | COREY | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 320848 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336792848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8554212733 | ||||||||
| FaxNumber: | 8133740491 | ||||||||
| Practice Location | |||||||||
| Address1: | 119 OAKFIELD DR | ||||||||
| Address2: | |||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335115779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8554212733 | ||||||||
| FaxNumber: | 8133740491 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2009 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS11679 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | DO-0112 | GU | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.