Provider Demographics
NPI:1699741009
Name:ALEXANDRAKI, IRENE (MD)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:ALEXANDRAKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MICCOSUKEE ROAD
Mailing Address - Street 2:INTERNAL MEDICINE RESIDENCY PROGRAM
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-431-8250
Mailing Address - Fax:850-431-8251
Practice Address - Street 1:1300 MICCOSUKEE ROAD
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY PROGRAM
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-431-8250
Practice Address - Fax:850-431-8251
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85205207R00000X, 208M00000X
TXK8707207R00000X, 207RI0200X
FLME83006207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2705451-00Medicaid
CA1699741009Medicaid
GA288918803AMedicaid
CA1699741009Medicaid
FL2705451-00Medicaid
GA288918803AMedicaid
DC49001ZMedicare PIN