Healthcare Provider Details

I. General information

NPI: 1437353554
Provider Name (Legal Business Name): ALISA SUZANNE PIERCE-KEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4683 VAN DYKE RD
LUTZ FL
33558-4880
US

IV. Provider business mailing address

PO BOX 743409
ATLANTA GA
30374-3409
US

V. Phone/Fax

Practice location:
  • Phone: 813-968-7171
  • Fax: 813-443-8167
Mailing address:
  • Phone: 727-532-0002
  • Fax: 727-532-1325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME99227
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: