MEDICARE: ALEXANDRA DUBOIS CORONA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW23799	FL

General Provider Information

NPI Number	:	1093671596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA DUBOIS CORONA LCSW

Provider Business Mailing Address
First Line	:	11225 ESTIA DR UNIT 202
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34211-2390
Country	:	US
Telephone Number	:	941-302-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 MANATEE AVE W STE L101
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-2364
Country	:	US
Telephone Number	:	941-302-2211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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