Provider Demographics
NPI:1225611759
Name:CARDENAS, ALEXIS NOELLE (CAA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:NOELLE
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22250
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-0001
Mailing Address - Country:US
Mailing Address - Phone:844-268-4820
Mailing Address - Fax:631-201-3179
Practice Address - Street 1:300 PALM BEACH LAKES BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2710
Practice Address - Country:US
Practice Address - Phone:561-657-4600
Practice Address - Fax:561-657-4605
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAA669367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA669OtherSTATE LICENSE