Provider Demographics
NPI:1609508027
Name:PANTOJA, ALECKSANDRA (APRN)
Entity Type:Individual
Prefix:
First Name:ALECKSANDRA
Middle Name:
Last Name:PANTOJA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 NE 24TH LOOP
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-6208
Mailing Address - Country:US
Mailing Address - Phone:352-215-5494
Mailing Address - Fax:
Practice Address - Street 1:7400 NE 24TH LOOP
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-6208
Practice Address - Country:US
Practice Address - Phone:352-215-5494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020437363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology