Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alyssa San Diego, PA-C

Individual provider Physician Assistant · NPI 1194593376

Alyssa San Diego, PA-C is a Physician Assistant in Davenport, Florida. Qualified in 2022, 4 years ago. Practices with Excel Pain and Spine LLC, a 15-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2310 N Blvd W Ste A
Davenport, FL 33837-8988
Phone: (813) 701-5804
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1194593376
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 18, 2023
Last updated in NPPESMarch 2, 2025
Certification dateMarch 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Excel Pain And Spine Llc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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