Healthcare Provider Details

I. General information

NPI: 1750211827
Provider Name (Legal Business Name): ALEXIS LATORRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 ESTANCIA LN
CAPE CORAL FL
33909-5443
US

IV. Provider business mailing address

3193 ESTANCIA LN
CAPE CORAL FL
33909-5443
US

V. Phone/Fax

Practice location:
  • Phone: 239-898-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11047638
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: