Provider Demographics
NPI:1497473185
Name:BISHOP, ALEXANDRIA (NP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 N FEDERAL HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3203
Mailing Address - Country:US
Mailing Address - Phone:954-866-9699
Mailing Address - Fax:
Practice Address - Street 1:5400 N FEDERAL HWY STE 102
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3203
Practice Address - Country:US
Practice Address - Phone:954-866-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily