Provider Demographics
NPI:1679775738
Name:ALEXANDER, CHRISTIENNE P (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIENNE
Middle Name:P
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 W CALL ST SUITE 3210-A
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306-4300
Mailing Address - Country:US
Mailing Address - Phone:850-644-7029
Mailing Address - Fax:850-645-0577
Practice Address - Street 1:1115 W CALL ST SUITE 3210-A
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306
Practice Address - Country:US
Practice Address - Phone:850-644-7029
Practice Address - Fax:850-645-0577
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ726YMedicare PIN
FS0157607OtherDEA #
FLAJ726XMedicare PIN