Healthcare Provider Details

I. General information

NPI: 1366922478
Provider Name (Legal Business Name): ALISHA MICHELLE BUCHANAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 TAMPA GENERAL CIR STE 610
TAMPA FL
33606-3659
US

IV. Provider business mailing address

10002 PRINCESS PALM AVE STE 332
TAMPA FL
33619-8327
US

V. Phone/Fax

Practice location:
  • Phone: 813-315-4327
  • Fax: 813-315-4329
Mailing address:
  • Phone: 813-571-7184
  • Fax: 813-654-4695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9483152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: