Provider Demographics
NPI:1104417658
Name:CAPECCHI RODRIGUEZ, MARIA ALEXANDRA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ALEXANDRA
Last Name:CAPECCHI RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ALEXANDRA
Other - Last Name:CAPECCHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8727 TEMPLE TERRACE HWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-6700
Mailing Address - Country:US
Mailing Address - Phone:813-796-5400
Mailing Address - Fax:813-776-0079
Practice Address - Street 1:8727 TEMPLE TERRACE HWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-6700
Practice Address - Country:US
Practice Address - Phone:813-796-5400
Practice Address - Fax:813-776-0079
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9494593363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily