Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | LP03808 | RI |
N | 111NI0900X | Internist | LP03808 | RI |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME146640 | FL |
NPI | 1003293671 |
---|---|
Provider Name | Dr. Alexandra Cristina Villasante Fricke |
First Address | Miami, FL 33256-0823 |
Second Address | San Francisco, CA 94105-3174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2015 |
Last Update Date | 11/01/2022 |