Individual
MS. ALEXIS DANIELLE RAHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3527 TABERNACLE PL, TAMPA, FL 33607-5834
(863) 397-8385
Mailing address
3810 NORTHDALE BLVD, STE 150, TAMPA, FL 33624-1871
(863) 397-8385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9112570
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9112570
FLORIDA PHYSICIAN ASSISTANT LICENSE
FL
Enumeration date
09/21/2019
Last updated
06/23/2021
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