Organization
SELECT PHYSICIANS ALLIANCE PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL A WATTS (COO)
(813) 571-7184
Entity
Organization
Contact information
Practice address
10002 PRINCESS PALM AVE STE 332, TAMPA, FL 33619
(813) 571-7184
(813) 654-4695
Mailing address
10002 PRINCESS PALM AVE STE 332, TAMPA, FL 33619-8327
(813) 571-7184
(813) 654-4695
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YP0228X
Pediatric Otolaryngology Physician
—
—
207YS0012X
Sleep Medicine (Otolaryngology) Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
207YX0901X
Otology & Neurotology Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004140000
—
FL
01
—
FM218B
MEDICARE PTAN
FL
Enumeration date
07/28/2011
Last updated
07/21/2022
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