Provider Demographics
NPI:1548663818
Name:BARTLETT, ALEXANDRIA (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 PALM BEACH LAKES BOULEVARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-681-9808
Mailing Address - Fax:
Practice Address - Street 1:2031 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6501
Practice Address - Country:US
Practice Address - Phone:561-681-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108091363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant