Provider Demographics
NPI:1710409206
Name:ALEXANDROU, MARISA (APRN)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:ALEXANDROU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 UPPER CREEK DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6825
Mailing Address - Country:US
Mailing Address - Phone:813-773-1285
Mailing Address - Fax:813-253-2279
Practice Address - Street 1:1988 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3550
Practice Address - Country:US
Practice Address - Phone:727-953-8090
Practice Address - Fax:727-953-8088
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily