Individual
MRS. ALEXANDRA BLUE SANROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 S UNIVERSITY AVE, LITTLE ROCK DERMATOLOGY CLINIC SUITE 301, LITTLE ROCK, AR 72205-5302
(501) 664-4161
(501) 664-6108
Mailing address
500 S UNIVERSITY AVE, LITTLE ROCK DERMATOLOGY CLINIC SUITE 301, LITTLE ROCK, AR 72205-5302
(501) 664-4161
(501) 664-6108
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
P-T1551
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P-T1551
STATE
AR
Enumeration date
11/09/2015
Last updated
10/20/2022
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