Healthcare Provider Details

I. General information

NPI: 1881186096
Provider Name (Legal Business Name): ALEXANDRA GABRIELLE BARLOTTA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 MAR WALT DR UNIT 230
FT WALTON BCH FL
32547-6661
US

IV. Provider business mailing address

1032 MAR WALT DR UNIT 230
FT WALTON BCH FL
32547-6661
US

V. Phone/Fax

Practice location:
  • Phone: 850-862-3194
  • Fax: 850-565-0270
Mailing address:
  • Phone: 850-862-3194
  • Fax: 850-565-0270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704420283
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9251216
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: