Individual
ILANA MULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4301 N HABANA AVE, TAMPA, FL 33607-6546
(813) 876-0951
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 315-7469
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10460
GA
363AM0700X
Medical Physician Assistant
Primary
PA9117002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117668200
—
FL
Enumeration date
08/20/2021
Last updated
08/04/2023
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