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General NPI Number Information
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NPI Number | 1982397246
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Entity Type | Individual
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Provider Name | ALEXANDER PIERETTI PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 1125 S 6TH AVE
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City | WAUCHULA
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State | FL
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Zip | 33873-3350
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Country | US
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Telephone | 863-767-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 9404 MIDNIGHT BLUE CT APT 301
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City | RIVERVIEW
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State | FL
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Zip | 33578-4870
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Country | US
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Telephone | 650-676-7311
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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 | PA9117476
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License Number State | FL
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