| Doctor Name: | ALYSSA ANN CAVANAUGH |
| NPI Number: | 1063762177 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP9277224 |
| Business Practice Address: | 1397 Medical Park Blvd Suite 460 Wellington, FL - 334143186 |
| Business Phone Number: | 5617952878 |
| Business Fax Number: | 5617950464 |
| Mailing Address: | 1397 Medical Park Blvd, Suite 460 WELLINGTON |
| State: | FL |
| Postal Code: | 334143186 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2012 |
| NPI Last Update Date: | 09/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9277224 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |