Provider Demographics
NPI:1720326572
Name:AULISIO, ALEXIS (NP-C)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:AULISIO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 BEACH BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-4303
Mailing Address - Country:US
Mailing Address - Phone:904-241-8300
Mailing Address - Fax:904-241-0831
Practice Address - Street 1:905 BEACH BLVD STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4303
Practice Address - Country:US
Practice Address - Phone:042-418-3009
Practice Address - Fax:904-241-0831
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270145363LF0000X
FL9472988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily