Provider Demographics
NPI:1457713307
Name:GARCIA, ALEXANDRA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 CALLE DE DIEGO APT 1905
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-3057
Mailing Address - Country:US
Mailing Address - Phone:787-478-5838
Mailing Address - Fax:
Practice Address - Street 1:444 CALLE DE DIEGO APT 1905
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3057
Practice Address - Country:US
Practice Address - Phone:787-478-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily