Provider Demographics
NPI:1932858693
Name:PANVINI, ALEXANDER (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:PANVINI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:561-477-7000
Mailing Address - Fax:561-477-7707
Practice Address - Street 1:19615 STATE ROAD 7 STE 32
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4700
Practice Address - Country:US
Practice Address - Phone:561-477-7000
Practice Address - Fax:561-477-7707
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS22805208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics