MEDICARE: MR. ALEX A LOUKAS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2921092	FL

General Provider Information

NPI Number	:	1447295738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEX A LOUKAS RN

Provider Business Mailing Address
First Line	:	2112 W SOUTHVIEW AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3106
Country	:	US
Telephone Number	:	813-363-1464
Fax Number	:	407-648-6208

Provider Business Practice Location Address
First Line	:	2112 W SOUTHVIEW AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3106
Country	:	US
Telephone Number	:	813-363-1464
Fax Number	:	407-648-6208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	07/21/2022

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