Most Relevant Information
Provider Data
| NPI Number: | 1003301995 |
| Provider Name: | ALYSSA HENRY PROFFITT PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/25/2018 |
| Last Updated: | 06/20/2023 |
Provider Practice Location
212 LAKE RAY RD
HAWTHORNE
FL
326405706
Practice Location Phone/Fax
| Phone: | 3522841402 |
| Fax: |
Provider Mailing Location
208 LAKE RAY RD
HAWTHORNE
FL
326405706
Provider Mailing Phone/Fax
| Phone: | 3522841402 |
| Fax: |