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General NPI Number Information
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NPI Number | 1346937885
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Entity Type | Individual
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Provider Name | ALEXANDRA MCCLUSKEY NP
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Gender | Female
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 4725 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4603
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Country | US
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Telephone | 954-542-8540
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Fax | 954-542-8176
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Provider Business Mailing Address
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Address Line | 610 SW 15TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-1602
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Country | US
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Telephone | 772-341-5579
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11025352
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License Number State | FL
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