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General NPI Number Information
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NPI Number | 1033053624
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Entity Type | Individual
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Provider Name | ALEXANDRE MACLELLAN NP
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Gender | Male
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 10048 US HIGHWAY 301 N PARRISH, FL, 34219
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City | PARRISH
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State | FL
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Zip | 34219
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Country | US
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Telephone | 941-231-8825
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Fax |
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Provider Business Mailing Address
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Address Line | 9704 DAYBREAK GLN
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City | PARRISH
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State | FL
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Zip | 34219-1389
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Country | US
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Telephone | 941-231-8825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2025093895
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License Number State | FL
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