MEDICARE: ALEXANDRA COLLINS PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9305676	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11043668	FL

General Provider Information

NPI Number	:	1487524807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA COLLINS PMHNP-BC

Provider Business Mailing Address
First Line	:	19359 YELLOW CLOVER DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3669
Country	:	US
Telephone Number	:	813-347-8289
Fax Number	:

Provider Business Practice Location Address
First Line	:	4931 CAMELOT ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-3321
Country	:	US
Telephone Number	:	941-310-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	12/30/2025

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