Provider Demographics
NPI:1376719336
Name:CAVALCANTE, ALESSANDRO A (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:ALESSANDRO
Middle Name:A
Last Name:CAVALCANTE
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 E ALTAMONTE DR STE 2200
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4653
Mailing Address - Country:US
Mailing Address - Phone:407-767-0009
Mailing Address - Fax:407-767-0022
Practice Address - Street 1:460 E ALTAMONTE DR STE 2200
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-767-0009
Practice Address - Fax:407-767-0022
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA910533363A00000X, 363A00000X
MEPA1519363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPA1519OtherMAINE LICENSE
FLPA9105334OtherFL LICENSE NUMBER