Individual
ALISA ZAGORODNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
9320 STATE ROAD 54, TRINITY, FL 34655-1808
(727) 493-2513
(877) 917-2336
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 432-8500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11000471
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10708300
—
FL
Enumeration date
12/07/2018
Last updated
03/22/2023
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