Healthcare Provider Details

I. General information

NPI: 1225440852
Provider Name (Legal Business Name): ALRICK LESHONDA DAVIS DRUMMOND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13043 SUMMERFIELD SQUARE DR
RIVERVIEW FL
33578-7402
US

IV. Provider business mailing address

13043 SUMMERFIELD SQUARE DR
RIVERVIEW FL
33578-7402
US

V. Phone/Fax

Practice location:
  • Phone: 813-677-2222
  • Fax: 813-677-2241
Mailing address:
  • Phone: 813-677-2222
  • Fax: 813-677-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL36894
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME136110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: