Healthcare Provider Details

I. General information

NPI: 1114622719
Provider Name (Legal Business Name): ALEXAUNDRIA CAMILLE BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21097 NE 27TH CT STE 205
AVENTURA FL
33180-1237
US

IV. Provider business mailing address

21097 NE 27TH CT STE 205
AVENTURA FL
33180-1237
US

V. Phone/Fax

Practice location:
  • Phone: 754-778-7689
  • Fax:
Mailing address:
  • Phone: 765-778-7689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number179853
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: