Healthcare Provider Details

I. General information

NPI: 1437875630
Provider Name (Legal Business Name): PRIYA ALEXANDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W HILLSBORO BLVD
DEERFIELD BEACH FL
33441-1604
US

IV. Provider business mailing address

450 W HILLSBORO BLVD
DEERFIELD BEACH FL
33441-1604
US

V. Phone/Fax

Practice location:
  • Phone: 954-531-0461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9116657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: