Healthcare Provider Details

I. General information

NPI: 1609339233
Provider Name (Legal Business Name): ALEXA J QUINN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 DEL PRADO BLVD N STE 301
CAPE CORAL FL
33909-2278
US

IV. Provider business mailing address

632 DEL PRADO BLVD N STE 301
CAPE CORAL FL
33909-2278
US

V. Phone/Fax

Practice location:
  • Phone: 239-768-2111
  • Fax: 239-482-4404
Mailing address:
  • Phone: 239-768-2111
  • Fax: 239-482-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS18856
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: