Provider Demographics
NPI:1982313482
Name:MCALVANY, ALEXANDRA LYNNE (PA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LYNNE
Last Name:MCALVANY
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 1:15303 AMBERLY DR STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2308
Mailing Address - Country:US
Mailing Address - Phone:813-751-9127
Mailing Address - Fax:813-441-7373
Practice Address - Street 1:15303 AMBERLY DR STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2308
Practice Address - Country:US
Practice Address - Phone:813-751-9127
Practice Address - Fax:813-441-7373
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
FLPA9116278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant