Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | C1-0010037 | DE |
Y | 207RP1001X | Pulmonary Disease | ME142088 | FL |
NPI | 1063733855 |
---|---|
Provider Name | Alexandra V Perry |
First Address | Jacksonville, FL 32214-5005 |
Second Address | Middleburg, FL 32068-8459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2010 |
Last Update Date | 26/05/2020 |