Individual
MRS. ALEXIS MADDERN LOVELACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 SW 28TH ST, GAINESVILLE, FL 32607-3139
(904) 334-9383
Mailing address
501 SW 28TH ST, GAINESVILLE, FL 32607-3139
(904) 334-9383
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109447
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018188800
—
FL
Enumeration date
04/05/2016
Last updated
10/07/2016
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