Individual
ELYSSA EMILY PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A
Contact information
Practice address
12512 BRUCE B. DOWNS BLVD, TAMPA, FL 33612
(813) 977-8700
(813) 975-8138
Mailing address
16705 WHISPERING GLEN DR., LUTZ, FL 33558
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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