Provider Demographics
NPI:1558479485
Name:STEPHAN ALESSANDRONI, VERONICA MARGARET (PA-C)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MARGARET
Last Name:STEPHAN ALESSANDRONI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:MARGARET
Other - Last Name:STEPHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 198441
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8441
Mailing Address - Country:US
Mailing Address - Phone:813-745-7365
Mailing Address - Fax:
Practice Address - Street 1:12902 USF MAGNOLIA DR
Practice Address - Street 2:WCB-RAD MD/OPI
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:813-975-4278
Practice Address - Fax:813-745-1535
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101852363A00000X
WAPA10002011363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant