Healthcare Provider Details

I. General information

NPI: 1104744333
Provider Name (Legal Business Name): ALEXANDRA DALLESSIO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9125 CORSEA DEL FONTANA WAY STE 100
NAPLES FL
34109-4430
US

IV. Provider business mailing address

900 VILLAGE SQUARE XING STE 290
PALM BEACH GARDENS FL
33410-4552
US

V. Phone/Fax

Practice location:
  • Phone: 239-598-4004
  • Fax: 239-598-4713
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: