Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. In Soon Park, MD

Individual provider Surgery Physician · NPI 1083646350

Dr. In Soon Park, MD is a General Surgery in Brandon, Florida. Graduated from Rutgers R W Johnson Medical School (CAM/NEW Bruns/Pisc) in 1995, 31 years ago. Practices with Physicians Professional Alliance LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
31
Trained at
Rutgers R W Johnson Medical School (CAM/NEW Bruns/Pisc)
Licensed in
FL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

519 Medical Oaks Ave
Brandon, FL 33511
Phone: (813) 685-7995
Fax: (813) 685-8802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence ME93268 (FL)

Record details

NPI number1083646350
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 7, 2006
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolRUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated 1995 (31 years in practice)
Group practice Physicians Professional Alliance Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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