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General NPI Number Information
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NPI Number | 1275820045
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Entity Type | Organization
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Legal Business Name | ALEXANDER KISS MD,PA
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 38168 MEDICAL CENTER AVE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540-1380
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Country | US
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Telephone | 813-788-0378
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Fax | 813-788-6688
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Provider Business Mailing Address
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Address Line | 38168 MEDICAL CENTER AVE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540-1380
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Country | US
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Telephone | 813-788-0378
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Fax | 813-788-6688
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER KISS
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Credential | MD
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Telephone | 813-788-0378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME0056104
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License Number State | FL
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