Provider Demographics
NPI:1548767163
Name:RODICA, ALEXA LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:LEE
Last Name:RODICA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 BAYSHORE BLVD APT 15D
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-1703
Mailing Address - Country:US
Mailing Address - Phone:727-424-8970
Mailing Address - Fax:
Practice Address - Street 1:4144 N ARMENIA AVE STE 250
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6449
Practice Address - Country:US
Practice Address - Phone:813-333-9971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9350960363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health