Healthcare Provider Details

I. General information

NPI: 1598144669
Provider Name (Legal Business Name): ALEXANDRA H SCOMA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 45TH ST
WEST PALM BEACH FL
33407
US

IV. Provider business mailing address

901 45TH ST
WEST PALM BEACH FL
33407-2413
US

V. Phone/Fax

Practice location:
  • Phone: 561-882-6186
  • Fax: 561-882-6124
Mailing address:
  • Phone: 561-882-6186
  • Fax: 561-882-6124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS15305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: