Individual
AYESHA FALAK KIETZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13944 LAKESHORE BLVD STE C, HUDSON, FL 34667-1431
(727) 605-0252
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
(813) 745-7365
(813) 449-8618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112195
FL
Other
Enumeration date
04/24/2019
Last updated
01/09/2026
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