Provider Demographics
NPI:1588013114
Name:ANZARDO, ALEXANDER (ARNP)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:ANZARDO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11760 SW 40TH ST STE 722
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8101
Mailing Address - Country:US
Mailing Address - Phone:305-559-1883
Mailing Address - Fax:305-559-1887
Practice Address - Street 1:11760 SW 40TH ST STE 722
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8101
Practice Address - Country:US
Practice Address - Phone:305-559-1883
Practice Address - Fax:305-559-1887
Is Sole Proprietor?:No
Enumeration Date:2016-06-04
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9320952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily