Healthcare Provider Details

I. General information

NPI: 1639794563
Provider Name (Legal Business Name): ALEXANDRA FAITH MAHON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 THUMBWOOD CIR APT C
BOYNTON BEACH FL
33436-7905
US

IV. Provider business mailing address

8888 THUMBWOOD CIR APT C
BOYNTON BEACH FL
33436-7905
US

V. Phone/Fax

Practice location:
  • Phone: 954-540-2469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11005073
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: