Individual
ALISSA LAUREN KITCHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 59TH ST W STE 4200, BRADENTON, FL 34209-4687
(941) 794-3999
Mailing address
10965 CLARENDON ST, FORT MYERS, FL 33913-8562
(573) 673-2754
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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