Healthcare Provider Details

I. General information

NPI: 1215689054
Provider Name (Legal Business Name): ALEXANDRA MUNRO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 E ATLANTIC BLVD
POMPANO BEACH FL
33060-6345
US

IV. Provider business mailing address

PO BOX 850001, DEPT 8340
ORLANDO FL
32885-0001
US

V. Phone/Fax

Practice location:
  • Phone: 954-943-5044
  • Fax: 954-786-8502
Mailing address:
  • Phone: 813-536-7277
  • Fax: 855-830-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9115688
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: