Provider Demographics
NPI:1134429665
Name:MAJESTY, ALEXANDRA (PA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:MAJESTY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 SE OCEAN BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3301
Mailing Address - Country:US
Mailing Address - Phone:772-220-3339
Mailing Address - Fax:772-286-2635
Practice Address - Street 1:2220 SE OCEAN BLVD STE 301
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3301
Practice Address - Country:US
Practice Address - Phone:772-220-3339
Practice Address - Fax:772-286-2635
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-03505207N00000X, 363AM0700X
AZ4703363A00000X
NY017303363A00000X
CA22939363A00000X
FL9111171363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical