Provider Demographics
NPI:1417596255
Name:CAMUNAS MIRO, ALEXA KINDER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:KINDER
Last Name:CAMUNAS MIRO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 290
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5182
Mailing Address - Country:US
Mailing Address - Phone:941-254-6767
Mailing Address - Fax:
Practice Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 290
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5182
Practice Address - Country:US
Practice Address - Phone:941-254-6767
Practice Address - Fax:941-213-6991
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical