MEDICARE: MS. ALEXIS VANEISHA DRAYTON APRN

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	363LF0000X	Family Nurse Practitioner	10000044	OR
2	363LF0000X	Family Nurse Practitioner	APRN11007531	FL

General Provider Information

NPI Number	:	1831715366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALEXIS VANEISHA DRAYTON APRN

Provider Business Mailing Address
First Line	:	8400 NW 33RD ST STE 201
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33122-1937
Country	:	US
Telephone Number	:	844-665-4827
Fax Number	:	855-785-2883

Provider Business Practice Location Address
First Line	:	3617 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5713
Country	:	US
Telephone Number	:	813-675-2020
Fax Number	:	855-785-2883

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

Provider Enumeration Date	:	06/20/2020
Last Update Date	:	03/06/2025

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