Healthcare Provider Details

I. General information

NPI: 1205377645
Provider Name (Legal Business Name): ALYSSA FRANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2017
Last Update Date: 03/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 GRAND POPLAR ST
OCOEE FL
34761-7642
US

IV. Provider business mailing address

2400 GRAND POPLAR ST
OCOEE FL
34761-7642
US

V. Phone/Fax

Practice location:
  • Phone: 407-949-2197
  • Fax:
Mailing address:
  • Phone:
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: