Individual
ALYSA ROSE MEMOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN
Contact information
Practice address
9981 S HEALTHPARK DR STE 454, FORT MYERS, FL 33908-3618
(239) 343-9710
(239) 343-4178
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9710
(239) 343-4178
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9424850
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11020427
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114667300
—
FL
Enumeration date
06/23/2022
Last updated
08/03/2022
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