Provider Demographics
NPI:1861773533
Name:GRACE, ALEXANDRA (DO, MPH)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:GRACE
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1656 MEDICAL BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1423
Mailing Address - Country:US
Mailing Address - Phone:239-593-6201
Mailing Address - Fax:239-593-6202
Practice Address - Street 1:1656 MEDICAL BLVD STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1423
Practice Address - Country:US
Practice Address - Phone:239-593-6201
Practice Address - Fax:239-593-6202
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11409207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine