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General NPI Number Information
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NPI Number | 1114203536
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Entity Type | Individual
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Provider Name | ALEXANDRA DORMOY PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 5995 SW 71ST ST STE 403-B
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City | SOUTH MIAMI
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State | FL
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Zip | 33143
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Country | US
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Telephone | 305-665-6926
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Fax | 305-661-2003
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Provider Business Mailing Address
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Address Line | 5995 SW 71ST ST STE 403-B
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3531
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Country | US
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Telephone | 305-665-6926
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Fax | 305-661-2003
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9106264
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License Number State |
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