Provider Demographics
NPI:1114203536
Name:DORMOY, ALEXANDRA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:DORMOY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 SW 71ST ST STE 403-B
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3531
Mailing Address - Country:US
Mailing Address - Phone:305-665-6926
Mailing Address - Fax:305-661-2003
Practice Address - Street 1:5995 SW 71ST ST STE 403-B
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-665-6926
Practice Address - Fax:305-661-2003
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9106264363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant