Provider Demographics
NPI:1710929922
Name:FLOYD, ALICE LOUISE (ARNP, CWCN)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:LOUISE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:ARNP, CWCN
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:SIMPSON
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1755 DAVID WALKER DR
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-5745
Mailing Address - Country:US
Mailing Address - Phone:352-742-8830
Mailing Address - Fax:352-742-8826
Practice Address - Street 1:1755 DAVID WALKER DR
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5745
Practice Address - Country:US
Practice Address - Phone:352-742-8830
Practice Address - Fax:352-742-8826
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1649742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5924OtherBCBS
FLY5924OtherBCBS
FLY5924ZMedicare PIN