Individual
ALICIA B REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
25 W CRYSTAL LAKE ST, SUITE 200, ORLANDO, FL 32806-4475
(407) 254-2522
(407) 254-2557
Mailing address
25 W CRYSTAL LAKE ST, SUITE 200, ORLANDO, FL 32806-4475
(407) 254-2522
(407) 254-2557
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9105282
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 9105282
MEDICAL LICENSE
FL
Enumeration date
10/26/2009
Last updated
01/15/2015
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