Provider Demographics
NPI:1669423562
Name:PETROVIC, ALEKSANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDRA
Middle Name:
Last Name:PETROVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEKSANDRA
Other - Middle Name:
Other - Last Name:KIROVSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 5TH ST S
Mailing Address - Street 2:DEPT 6500002705
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4801
Mailing Address - Country:US
Mailing Address - Phone:727-767-6856
Mailing Address - Fax:727-767-7472
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:DEPT 7865
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4801
Practice Address - Country:US
Practice Address - Phone:727-767-6856
Practice Address - Fax:727-767-7472
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME881672080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267743100Medicaid