Individual
ALFRED IZELL RUSH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
909 E 20TH AVE, TAMPA, FL 33605-2548
(727) 288-8036
(813) 200-1993
Mailing address
909 E 20TH AVE, TAMPA, FL 33605-2548
(727) 822-3544
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9260658
FL
Other
Enumeration date
06/07/2018
Last updated
12/18/2019
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