Healthcare Provider Details

I. General information

NPI: 1932858693
Provider Name (Legal Business Name): ALEXANDER PANVINI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19615 STATE ROAD 7 STE 32
BOCA RATON FL
33498-4700
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 561-477-7000
  • Fax: 561-477-7707
Mailing address:
  • Phone: 561-477-7000
  • Fax: 561-477-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS22805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: