Alexander Medical Group LLC
Organization Active NPI Orthopaedic Surgery Physician · Largo, FL
NPI 1265453286 · NPPES record last updated Sep 19, 2018
Key facts
- NPI
- 1265453286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- ME 77329 (FL)
- Legal business name
- ALEXANDER MEDICAL GROUP LLC
- Practice address
- 12416 66TH Street N
Suite a
Largo, FL 33773-3437 - Phone
- (727) 547-4700
- Fax
- (727) 394-8661
- NPI assigned
- Jul 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Sherry Jackasal-Labonte
- Title
- Office Manager
- Phone
- (727) 547-4700
Member organizations 1
Practitioners 39
-
Vladimir A Alexander, M.D.
-
James M Cottom, DPM
-
Jonathan Ross Dattilo, M.D.
-
Elizabeth Davide, PA-C
-
Jennifer Carol Devitt, MSPT
-
Adam Kopiec, MD
-
Andrew Carroll Mundy, M.D.
-
Thomas E Odmark, MD
-
Daniel Penello, M.D. MBA
-
Valerie Starr Smith, MPT
-
Jennifer Swaringen, M.D.
-
Scott Vizzi, M.D.
-
Ali Zahrai, MD
-
Matthew L Wahl, MD
-
Heather Christen Collazo, PA-C
-
Kiarra Pena Corless, MMS, PA-C
-
Juliana K Guida, PA-C
-
Megan Lynn Guzzardi, MPAS
-
Jennifer N Wethington, P.A.-C, MS
-
Erin A Wildt, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050808000162 | FL | Part B Supplier - Clinic/Group Practice | 0547299836 |
Receives reassigned benefits from 38 practitioners Practice locations: Englewood, FL; Largo, FL; New Port Richey, FL; Palm Harbor, FL; Sarasota, FL; St. Petersburg, FL |
| O20100930030194 | FL | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 0547299836 | Practice locations: Largo, FL |
National Provider Directory
Locations
697 Old Englewood Rd
Englewood, FL 34223
Phone (941) 475-3839
2114 Seven Springs Blvd
Ste 250
New Port Richey, FL 34655
Phone (727) 375-1907
2114 Seven Springs Blvd
Ste 25
New Port Richey, FL 34655
2830 Bee Ridge Rd
Sarasota, FL 34239
Phone (941) 342-6505
5911 N Honore Ave
Ste 120
Sarasota, FL 34243
Phone (941) 355-3223
1609 Pasadena Ave S
Ste 4E
South Pasadena, FL 33707
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | ME 77329 | FL | Yes |
Addresses
Primary practice location
12416 66TH Street N
Suite a
Largo, FL 33773-3437
Mailing address
12416 66TH St
Largo, FL 33773-3437
Phone (727) 547-4700
Other names
- Alexander Orthopaedic Associates
Other providers in Largo, FL
- Nicole Albert
- Alberto M. Bird, DMD,MSCD,PA
- Albertsons LLC
- Albertsons LLC
- Christopher James Alepa
- Alexander T Gimon PHD PA
- Alexander T Gimon PHD PA
- Vladimir A Alexander
- Ayten Alhanash
- Munibah Rahat Ali
All providers in Largo, FL · Orthopaedic Surgery Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.