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General NPI Number Information
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NPI Number | 1508730235
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Entity Type | Individual
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Provider Name | ALEXANDRA WEAVER PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 7431 N UNIVERSITY DR STE 300
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City | TAMARAC
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State | FL
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Zip | 33321-2956
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Country | US
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Telephone | 954-724-5560
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Fax |
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Provider Business Mailing Address
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Address Line | 2697 OAK TREE DR
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City | OAKLAND PARK
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State | FL
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Zip | 33309-6704
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Country | US
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Telephone | 954-604-4155
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9120826
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License Number State | FL
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