Healthcare Provider Details

I. General information

NPI: 1922492206
Provider Name (Legal Business Name): ALEXANDRA PLICHTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 06/04/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE STE C300
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1611 NW 12TH AVE STE C300
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-393-2420
  • Fax:
Mailing address:
  • Phone: 305-393-2420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number278977
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME161454
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD91582
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number303290
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: