Provider Demographics
NPI:1659258549
Name:JACOME, ALEXA (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:JACOME
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 1:7722 NW 114TH PL
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1388
Mailing Address - Country:US
Mailing Address - Phone:305-986-0981
Mailing Address - Fax:
Practice Address - Street 1:7722 NW 114TH PL
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-1388
Practice Address - Country:US
Practice Address - Phone:305-986-0981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant