Individual
ALEXANDRIA WEST DIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1228 S PINE ISLAND RD STE 410, PLANTATION, FL 33324-4583
(954) 837-1490
(954) 837-1188
Mailing address
PO BOX 743144, ATLANTA, GA 30374-3144
(954) 837-1490
(954) 837-1188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9262193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017959200
—
FL
Enumeration date
08/30/2015
Last updated
02/10/2022
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