# ALEXANDER PUSHKA MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205101862
- **Authorized official:** ALEXANDER PUSHKA MD (OWNER)
- **Authorized official phone:** (954) 579-1110

## Contact information

- **Practice address:** 7369 SHERIDAN ST STE 203, HOLLYWOOD, FL 33024-2776
- **Practice address phone:** (954) 983-5330
- **Practice address fax:** (954) 983-5086
- **Mailing address:** 7369 SHERIDAN ST STE 203, HOLLYWOOD, FL 33024-2776
- **Mailing address phone:** (954) 983-5330
- **Mailing address fax:** (954) 983-5086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | ME88666 | FL | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | ME88666 | FL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/15/2012
- **Last updated:** 08/12/2020