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NPI Code Detail

MEDICARE: TINA MARIE D'ALESSANDRO PH.D., PMHNP-BC

MEDICARE:   TINA MARIE D'ALESSANDRO  PH.D., PMHNP-BC
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
1363L00000XNurse PractitionerARNP1893082FL
2363LF0000XFamily Nurse PractitionerARNP1893082FL
3363LP0808XPsychiatric/Mental Health Nurse PractitionerARNP1893082FL

Other Identifiers

General Provider Information

NPI Number : 1568501351
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA MARIE D'ALESSANDRO PH.D., PMHNP-BC
Provider Business Mailing Address
First Line : 3333 W 20TH ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32254-1703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3333 W 20TH ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32254-1703
Country : US
Telephone Number : 904-695-9145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 03/07/2024

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Directions to “ TINA MARIE D'ALESSANDRO PH.D., PMHNP-BC” Practice Location

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