Provider Demographics
NPI:1225409725
Name:GRIFFIN, ALICIA F (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:F
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8007 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4462
Mailing Address - Country:US
Mailing Address - Phone:813-690-3257
Mailing Address - Fax:
Practice Address - Street 1:7406 FULLERTON ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-3552
Practice Address - Country:US
Practice Address - Phone:904-538-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9308382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily