Provider Demographics
NPI:1528154143
Name:ALEXANDER, SANDRA M (MS, ARNP)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:M
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MS, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8145 CEREBELLUM WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1788
Mailing Address - Country:US
Mailing Address - Phone:727-845-4999
Mailing Address - Fax:866-777-2195
Practice Address - Street 1:8145 CEREBELLUM WAY STE 101
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1788
Practice Address - Country:US
Practice Address - Phone:727-845-4999
Practice Address - Fax:866-777-2195
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1316472363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS95453Medicare UPIN
FLE3452XMedicare PIN
FLE3452YMedicare PIN