Healthcare Provider Details

I. General information

NPI: 1639005523
Provider Name (Legal Business Name): ALYSSA ROBERTS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 MADISON ST
NEW PORT RICHEY FL
34652-1971
US

IV. Provider business mailing address

8444 GREEN ST
PORT RICHEY FL
34668-6010
US

V. Phone/Fax

Practice location:
  • Phone: 172-784-2846
  • Fax:
Mailing address:
  • Phone: 484-432-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: