Individual
ALYSSA LANZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4202 E FOWLER AVE, PCD1017, TAMPA, FL 33620-6750
(813) 974-8844
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA16820
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020295600
—
FL
01
—
5SF0Y
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/02/2017
Last updated
12/14/2018
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