Healthcare Provider Details

I. General information

NPI: 1790692564
Provider Name (Legal Business Name): ALEXIS DENISE DARLING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 UNIVERSITY BLVD S STE 17
JACKSONVILLE FL
32216-4346
US

IV. Provider business mailing address

763 BURLWOOD CT
ORANGE PARK FL
32073-1649
US

V. Phone/Fax

Practice location:
  • Phone: 904-408-6344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9121915
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: