Healthcare Provider Details

I. General information

NPI: 1417166190
Provider Name (Legal Business Name): IZZO & ALKIRE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 TAMPA GENERAL CIR SUITE 860
TAMPA FL
33606-3601
US

IV. Provider business mailing address

5 TAMPA GENERAL CIR SUITE 860
TAMPA FL
33606-3601
US

V. Phone/Fax

Practice location:
  • Phone: 813-258-4533
  • Fax: 813-258-4733
Mailing address:
  • Phone: 813-258-4533
  • Fax: 813-258-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberFL
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. MARK J ALKIRE
Title or Position: ASSOC MEDICAL DIRECTOR
Credential: MD
Phone: 813-258-4533