Individual
MRS. ALYSSA BLUMENTHAL MALIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4710 N HABANA AVE, TAMPA, FL 33614-7161
(813) 444-3204
Mailing address
4710 N HABANA AVE STE 405, TAMPA, FL 33614-7152
(813) 789-6466
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN9395113
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023082600
—
FL
01
—
LB224
MEDICARE
FL
01
—
OETH4
BCBS
FL
Enumeration date
09/25/2017
Last updated
05/09/2022
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