Provider Demographics
NPI:1225640709
Name:PAGE, ALEXANDRIA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 W 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5612
Mailing Address - Country:US
Mailing Address - Phone:813-523-0473
Mailing Address - Fax:
Practice Address - Street 1:10928 CROSS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-4034
Practice Address - Country:US
Practice Address - Phone:813-986-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS608923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy