Provider Demographics
NPI:1679593917
Name:TAPIA, ALEJANDRO G (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:G
Last Name:TAPIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 310754
Mailing Address - Street 2:DEPT 4101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-0754
Mailing Address - Country:US
Mailing Address - Phone:561-255-3131
Mailing Address - Fax:561-622-4324
Practice Address - Street 1:1397 MEDICAL PARK BLVD STE 460
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3188
Practice Address - Country:US
Practice Address - Phone:561-472-5811
Practice Address - Fax:561-472-5811
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94437207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58299OtherBLUE CROSS BLUE SHEILD
FL007396800Medicaid
FL58299OtherBLUE CROSS BLUE SHEILD