Provider Demographics
NPI:1780706507
Name:ALESSANDRO, VERONICA A (ARNP-C)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:A
Last Name:ALESSANDRO
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 512700
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33951-2700
Mailing Address - Country:US
Mailing Address - Phone:941-629-3500
Mailing Address - Fax:941-629-3100
Practice Address - Street 1:18316 MURDOCK CIR UNIT 108
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1029
Practice Address - Country:US
Practice Address - Phone:941-629-3500
Practice Address - Fax:941-629-3100
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3365012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308894400Medicaid
FLP00617615OtherRR MEDICARE
FLP333090001Medicare UPIN
FLE5645WMedicare PIN
FLE5645XMedicare PIN