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NPI Code Detail

MEDICARE: ALYSSA SOUZA

MEDICARE: ALYSSA SOUZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner11044877FL
2363LP2300XPrimary Care Nurse Practitioner11044877FL
3363LA2200XAdult Health Nurse Practitioner11044877FL

General Provider Information

NPI Number : 1396603338
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA SOUZA
Provider Business Mailing Address
First Line : 6817 SOUTHPOINT PKWY STE 203
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6286
Country : US
Telephone Number : 352-904-3301
Fax Number :
Provider Business Practice Location Address
First Line : 6817 SOUTHPOINT PKWY STE 203
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6286
Country : US
Telephone Number : 352-904-3301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2026
Last Update Date : 02/23/2026

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Directions to “ ALYSSA SOUZA ” Practice Location

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