Healthcare Provider Details

I. General information

NPI: 1831764265
Provider Name (Legal Business Name): ALYSSA ANN FROST APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 05/27/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4460 SW 20TH AVE
OCALA FL
34471-0163
US

IV. Provider business mailing address

5081 SE 35TH AVE
OCALA FL
34480-8418
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-3800
  • Fax: 352-873-4800
Mailing address:
  • Phone: 352-286-5485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11013232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: