Healthcare Provider Details

I. General information

NPI: 1104518950
Provider Name (Legal Business Name): ALYSSIA FRANK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR
OCOEE FL
34761-3400
US

IV. Provider business mailing address

10000 W COLONIAL DR
OCOEE FL
34761-3400
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-6444
  • Fax:
Mailing address:
  • Phone: 321-841-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11017181
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11017181
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: