Individual
ALEXANDER PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
1677 WELLS RD STE C, ORANGE PARK, FL 32073-2383
(904) 215-8400
Mailing address
4580 RACE TRACK RD STE 102, ST JOHNS, FL 32259-2457
(904) 679-3537
(904) 481-8651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL4195
FL
363AM0700X
Medical Physician Assistant
Primary
PA9113666
FL
Other
Enumeration date
07/15/2015
Last updated
02/13/2026
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