Provider Demographics
NPI:1972150738
Name:ALEXANDER MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:ALEXANDER MEDICAL GROUP LLC
Other - Org Name:ALEXANDER ORTHOPAEDIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JACKASAL LABONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-547-4700
Mailing Address - Street 1:12416 66TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-3430
Mailing Address - Country:US
Mailing Address - Phone:727-547-4700
Mailing Address - Fax:727-394-8661
Practice Address - Street 1:2438 DR. M L KING JR STREET N
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704
Practice Address - Country:US
Practice Address - Phone:727-547-4700
Practice Address - Fax:727-394-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site