Provider Demographics
NPI:1417166190
Name:IZZO & ALKIRE MD PA
Entity Type:Organization
Organization Name:IZZO & ALKIRE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALKIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-258-4533
Mailing Address - Street 1:5 TAMPA GENERAL CIR
Mailing Address - Street 2:SUITE 860
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3601
Mailing Address - Country:US
Mailing Address - Phone:813-258-4533
Mailing Address - Fax:813-258-4733
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:SUITE 860
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-258-4533
Practice Address - Fax:813-258-4733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL204F00000X, 2086S0127X, 208G00000X
FLFL2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL187089OtherWELLCARE
FL2463923OtherAETNA
FL260851100Medicaid
FL45647OtherBX GROUP
FL2463923OtherAETNA