Provider Demographics
NPI:1265497473
Name:JUSTICZ, ALEXANDER G (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:G
Last Name:JUSTICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1608 SE 3RD AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2564
Mailing Address - Country:US
Mailing Address - Phone:954-355-4665
Mailing Address - Fax:954-355-4881
Practice Address - Street 1:1625 SE 3RD AVE STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-355-4665
Practice Address - Fax:954-355-4881
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031040208G00000X
FLME106017208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA572542OtherBCBS EDI
FLQ00677830OtherMEDICARE RR
GA00661548AMedicaid
GA330003473OtherRR MEDICARE
FL003190000Medicaid