Individual provider Active NPI

Alex De Alba

  • Registered Nurse
  • Fort Myers, FL
National Provider Identifier
1417844580
Registry record updated Jun 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9519600 Issued in FL
Practice address
4757 Mirage Bay Cir Unit 204
Fort Myers, FL 33966-6635
Phone
(407) 409-4298
NPI assigned
Jun 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9519600 FL Primary

Addresses

Primary practice location

4757 Mirage Bay Cir Unit 204
Fort Myers, FL 33966-6635

Mailing address

4757 Mirage Bay Cir Unit 204
Fort Myers, FL 33966-6635
Phone (407) 409-4298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9519600FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1750464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1417844580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4757 MIRAGE BAY CIR UNIT 204",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666635",
            "telephone_number": "407-409-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 MIRAGE BAY CIR UNIT 204",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666635",
            "telephone_number": "407-409-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ALBA",
        "first_name": "ALEX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-21",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9519600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2025; 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.