Provider Demographics
NPI:1508501180
Name:PATIENT DIRECTED CARE INC
Entity Type:Organization
Organization Name:PATIENT DIRECTED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:IEZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-245-1026
Mailing Address - Street 1:15511 N FLORIDA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1262
Mailing Address - Country:US
Mailing Address - Phone:813-931-0000
Mailing Address - Fax:813-709-7162
Practice Address - Street 1:15511 N FLORIDA AVE STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1262
Practice Address - Country:US
Practice Address - Phone:813-931-0000
Practice Address - Fax:813-709-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty