Provider Demographics
NPI:1447476031
Name:ALPHA FIRST ASSIST INC
Entity type:Organization
Organization Name:ALPHA FIRST ASSIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNARD
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:813-681-1230
Mailing Address - Street 1:3327 POWERLINE RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-1866
Mailing Address - Country:US
Mailing Address - Phone:813-681-1230
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:3327 POWERLINE RD
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-1866
Practice Address - Country:US
Practice Address - Phone:813-681-1230
Practice Address - Fax:888-329-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 3080432163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY081FOtherBLUE CROSS BLUE SHIELD FL