Individual
ALYSSA SAN DIEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2310 NORTH BLVD W STE A, DAVENPORT, FL 33837-8988
(813) 701-5804
Mailing address
2672 PATRICIAN CIR, KISSIMMEE, FL 34746-3292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
03/02/2025
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