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General NPI Number Information
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NPI Number | 1629326293
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Entity Type | Individual
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Provider Name | GREGORY ALEXANDER SYLVIA PA
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Gender | Male
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 1669 SE US HIGHWAY 19
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4849
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Country | US
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Telephone | 352-699-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 PINEHURST DR
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City | SPRING HILL
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State | FL
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Zip | 34606-3833
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Country | US
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Telephone | 352-277-5305
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9106707
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License Number State | FL
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