Provider Demographics
NPI:1871536334
Name:ALEXANDER, MYRIAM I (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MYRIAM
Middle Name:I
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MYRIAM
Other - Middle Name:ISMAELITE
Other - Last Name:MULLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:40 SW 12TH STREET
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6525
Mailing Address - Country:US
Mailing Address - Phone:352-291-0019
Mailing Address - Fax:352-291-0097
Practice Address - Street 1:2111 SW 20TH PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7734
Practice Address - Country:US
Practice Address - Phone:352-622-4251
Practice Address - Fax:352-622-0102
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144366 NP363LA2200X
FLARNP 9202381363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308662300Medicaid
FLY098COtherBCBS
FLQ78510Medicare UPIN
FLY098COtherBCBS