Individual
ALEJANDRO ANTONIO TARDENCILLA GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7040 LAKOTA DR APT 203, WOODBRIDGE, VA 22192-5395
(407) 923-8493
Mailing address
7040 LAKOTA DR APT 203, WOODBRIDGE, VA 22192-5395
(407) 923-8493
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
23-164
WI
Other
Enumeration date
05/12/2023
Last updated
09/11/2025
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