Healthcare Provider Details

I. General information

NPI: 1255710224
Provider Name (Legal Business Name): CRISTINA ALEKSEYENKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4229 SW HIGH MEADOWS AVE FL 2
PALM CITY FL
34990-3702
US

IV. Provider business mailing address

4229 SW HIGH MEADOWS AVE FL 2
PALM CITY FL
34990-3702
US

V. Phone/Fax

Practice location:
  • Phone: 772-261-6509
  • Fax: 772-251-0399
Mailing address:
  • Phone: 772-261-6509
  • Fax: 772-251-0399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS14479
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: