Healthcare Provider Details

I. General information

NPI: 1982415758
Provider Name (Legal Business Name): ALEXANDRA TRIPP PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 PINELLAS ST STE 400
CLEARWATER FL
33756-3356
US

IV. Provider business mailing address

206 HARRISON AVE
BELLEAIR BEACH FL
33786-3650
US

V. Phone/Fax

Practice location:
  • Phone: 727-445-1911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: