MEDICARE: ALLYSSA BOUVET APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	11044484	FL

General Provider Information

NPI Number	:	1023968583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSSA BOUVET APRN

Provider Business Mailing Address
First Line	:	30199 MARQUETTE AVE
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4486
Country	:	US
Telephone Number	:	813-779-6019
Fax Number	:

Provider Business Practice Location Address
First Line	:	6748 GALL BLVD
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-2545
Country	:	US
Telephone Number	:	813-779-6019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ ALLYSSA BOUVET APRN” Practice Location

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