MEDICARE: AVIN ALEX

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	363L00000X	Nurse Practitioner	9476896	FL

General Provider Information

NPI Number	:	1982547097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVIN ALEX

Provider Business Mailing Address
First Line	:	3123 PLEASANT WILLOW CT
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8187
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3123 PLEASANT WILLOW CT
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8187
Country	:	US
Telephone Number	:	813-454-5553
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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