Provider Demographics
NPI:1609944412
Name:PARR, ALEXANDER G (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:G
Last Name:PARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-958-5150
Mailing Address - Fax:954-958-5155
Practice Address - Street 1:6405 N FEDERAL HWY STE 401
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1421
Practice Address - Country:US
Practice Address - Phone:954-958-5150
Practice Address - Fax:954-958-5155
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN5597208600000X
FLME97964208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278623100Medicaid
FL278623100Medicaid