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General NPI Number Information
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NPI Number | 1245145887
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Entity Type | Individual
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Provider Name | ALYSSA VILLARREAL
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Gender | Female
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 4525 S FLORIDA AVE STE 25
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City | LAKELAND
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State | FL
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Zip | 33813-2184
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Country | US
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Telephone | 863-812-4065
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Fax |
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Provider Business Mailing Address
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Address Line | 14004 ROOSEVELT BLVD STE 613
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City | CLEARWATER
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State | FL
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Zip | 33762-3819
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Country | US
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Telephone | 727-475-5540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT45067
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License Number State | FL
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