Healthcare Provider Details

I. General information

NPI: 1205397650
Provider Name (Legal Business Name): ALEXANDER KUANG-TSU LU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 49TH ST N STE 206
ST PETERSBURG FL
33709-2147
US

IV. Provider business mailing address

7109 ESTERO CT
APOLLO BEACH FL
33572-2752
US

V. Phone/Fax

Practice location:
  • Phone: 727-999-8346
  • Fax: 877-743-4465
Mailing address:
  • Phone: 574-360-3471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberOS21071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: