Sandra Alexander, MD is a women-owned family medicine practice in Carlsbad's La Costa area on Calle Barcelona, providing primary care within the Perlman Clinic network. Her LGBTQ+-affirming practice model integrates Portuguese-language consultations with conventional diagnostics, coordinating integrative referrals with providers such as Aviara Acupuncture & Integrative Health in the Aviara area for patients exploring complementary pain-management approaches. A graduate of Universidade Gama Filho medical school in Brazil, she completed surgical residency at Mount Sinai Medical Center of Florida and a hand surgery fellowship at the University of Louisville School of Medicine before transitioning to general practice — a surgical background that sharpens her musculoskeletal assessment for upper-extremity injuries. That orthopedic evaluation framework complements the conservative spinal care at NuSpine Chiropractic - Bressi Ranch for patients whose joint complaints benefit from co-managed non-surgical intervention. Complex case protocols include diabetic wound staging, hypertension titration with ambulatory monitoring, and pre-operative medical clearance leveraging her surgical training background for risk stratification.