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NPI Code Detail

MEDICARE: ALEXANDRA BACON

MEDICARE: ALEXANDRA BACON
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1851955249
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA BACON
Provider Business Mailing Address
First Line : 13609 SE 53RD AVE
Second Line :
City : SUMMERFIELD
State : FL
Zip : 34491-2419
Country : US
Telephone Number : 603-236-9169
Fax Number :
Provider Business Practice Location Address
First Line : 2102 SW 20TH PL STE 302
Second Line :
City : OCALA
State : FL
Zip : 34471-0858
Country : US
Telephone Number : 877-823-4283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2019
Last Update Date : 02/10/2026

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Directions to “ ALEXANDRA BACON ” Practice Location

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