Basic Information
| Provider Information | |||||||||
| NPI: | 1720461775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERSAUD | ||||||||
| FirstName: | ALANNA | ||||||||
| MiddleName: | ALEXIS | ||||||||
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| Credential: | MSPAS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 N ORANGE AVE STE 401 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328044644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073037283 | ||||||||
| FaxNumber: | 4073030347 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E ROLLINS ST | ||||||||
| Address2: | CRITICAL CARE SPECIALISTS | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073037283 | ||||||||
| FaxNumber: | 4073030347 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2015 | ||||||||
| LastUpdateDate: | 09/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2015021174 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA9108743 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.