Provider Demographics
NPI:1972106722
Name:BARBOUR, ALEXIS LEIGH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:LEIGH
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 7TH ST S UNIT 718
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4083
Mailing Address - Country:US
Mailing Address - Phone:941-932-5223
Mailing Address - Fax:
Practice Address - Street 1:4895 E BAY DR UNIT 120
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6878
Practice Address - Country:US
Practice Address - Phone:727-330-3988
Practice Address - Fax:727-339-6999
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113794363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical