Healthcare Provider Details

I. General information

NPI: 1558332874
Provider Name (Legal Business Name): ALEXANDER RESTREPO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 01/12/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 1ST AVE
OCALA FL
34471-6504
US

IV. Provider business mailing address

160 JOHN F KENNEDY DR SUITE 103
ATLANTIS FL
33462
US

V. Phone/Fax

Practice location:
  • Phone: 352-351-7200
  • Fax: 352-867-1053
Mailing address:
  • Phone: 561-434-0060
  • Fax: 561-434-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS9491
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: