Provider Demographics
NPI:1871467050
Name:MENENDEZ SUAREZ, ALEXEIS (PMHNP)
Entity type:Individual
Prefix:
First Name:ALEXEIS
Middle Name:
Last Name:MENENDEZ SUAREZ
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 GUILES RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7636
Mailing Address - Country:US
Mailing Address - Phone:813-966-9522
Mailing Address - Fax:
Practice Address - Street 1:3105 W WATERS AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2869
Practice Address - Country:US
Practice Address - Phone:813-269-2920
Practice Address - Fax:813-269-2921
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2025065388363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty