Basic Information
Provider Information
NPI: 1043682891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OLINSKY
FirstName: ALEXANDRA
MiddleName: MARY
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STACK
OtherFirstName: ALEXANDRA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 2
Mailing Information
Address1: 400 N ASHLEY DR
Address2: SUITE 1625
City: TAMPA
State: FL
PostalCode: 336024300
CountryCode: US
TelephoneNumber: 8136355808
FaxNumber: 8138444972
Practice Location
Address1: 1 TAMPA GENERAL CIR
Address2: SUITE A327
City: TAMPA
State: FL
PostalCode: 336063571
CountryCode: US
TelephoneNumber: 8138444434
FaxNumber: 8138444972
Other Information
ProviderEnumerationDate: 10/20/2015
LastUpdateDate: 01/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XARNP 9415399FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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