Individual provider Active NPI

Alan Joseph Iezzi, M.D.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1952590028
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0046451 Issued in FL
Practice address
15511 N Florida Ave
Suite 401
Tampa, FL 33613-1220
Phone
(813) 963-3124
Fax
(813) 908-7735
NPI assigned
Oct 15, 2007
Last updated
Jun 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0046451 FL Primary

Addresses

Primary practice location

15511 N Florida Ave
Suite 401
Tampa, FL 33613-1220

Mailing address

15511 N Florida Ave
Suite D
Tampa, FL 33613-1263
Phone (813) 908-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000518 FL Practitioner - Family Practice 6002866902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

14310 N Dale Mabry Hwy
Suite 305
Tampa, FL 33618-2059
Phone (813) 615-7028

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0046451FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Florida Hospital Physician Group Inc Family Medicine CurrentSince Mar 20, 2017 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

15511 N Florida Ave
Ste 108
Tampa, FL 33613
Phone (813) 963-3124

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1952590028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15511 N FLORIDA AVE",
            "address_2": "SUITE D",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131263",
            "telephone_number": "813-908-8700",
            "fax_number": "813-908-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15511 N FLORIDA AVE",
            "address_2": "SUITE 401",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131220",
            "telephone_number": "813-963-3124",
            "fax_number": "813-908-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IEZZI",
        "first_name": "ALAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0046451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.