Alexander Medical Spa, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ALEXANDER MEDICAL SPA, PA

Practice address

3363 NE 163Rd St Ste 505
North Miami Beach, FL 33160-4423

Phone

(786) 801-3122

Fax

(305) 513-5214

NPI assigned

Jun 21, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alexander Tirado, PA-C

Title

Owner

Phone

(305) 962-1789

Specialties & licenses 1

Addresses

Other names 1

• Alexander Medical Aesthetics, Inc. Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1033788443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3363 NE 163RD ST STE 505",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331604423",
            "telephone_number": "786-801-3122",
            "fax_number": "305-513-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 NE 163RD ST STE 505",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331604423",
            "telephone_number": "786-801-3122",
            "fax_number": "305-513-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDER MEDICAL SPA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "TIRADO",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-962-1789",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alexander Medical Aesthetics, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Internal Medicine Physician in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.