Healthcare Provider Details

I. General information

NPI: 1033053624
Provider Name (Legal Business Name): ALEXANDRE MACLELLAN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10048 US HIGHWAY 301 N PARRISH, FL, 34219
PARRISH FL
34219
US

IV. Provider business mailing address

9704 DAYBREAK GLN
PARRISH FL
34219-1389
US

V. Phone/Fax

Practice location:
  • Phone: 941-231-8825
  • Fax:
Mailing address:
  • Phone: 941-231-8825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025093895
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: