MEDICARE: ALYSON ANNE BURKEYBILE PA-C

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	363A00000X	Physician Assistant	PA9112392	FL
2	363A00000X	Physician Assistant	2011005757	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932407897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON ANNE BURKEYBILE PA-C

Provider Business Mailing Address
First Line	:	787 CORTARO DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6812
Country	:	US
Telephone Number	:	813-634-2500
Fax Number	:	813-634-3008

Provider Business Practice Location Address
First Line	:	787 CORTARO DR
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-6812
Country	:	US
Telephone Number	:	813-634-2500
Fax Number	:	813-634-3008

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

Provider Enumeration Date	:	03/02/2011
Last Update Date	:	01/12/2026

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