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Individual

LUIS A ALICEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
7340 W WATERS AVE, TAMPA, FL 33634-2222
(813) 886-1800
Mailing address
2502 NORTH ROCKY POINT DRIVE, SUITE 1000-CREDENTIALING, TAMPA, FL 33607

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
2460
PR
1223P0700X
Prosthodontics
Primary
DN15801
FL

Other

Enumeration date
09/28/2006
Last updated
03/02/2009
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