Healthcare Provider Details

I. General information

NPI: 1386523363
Provider Name (Legal Business Name): ALEXANDRA SANGUILY FURTADO ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

973 SE FEDERAL HWY STE 973B
STUART FL
34994-3701
US

IV. Provider business mailing address

1584 SW CROSSING CIR
PALM CITY FL
34990-2450
US

V. Phone/Fax

Practice location:
  • Phone: 303-925-4750
  • Fax:
Mailing address:
  • Phone: 772-353-1317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11049486
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number11049486
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: