Healthcare Provider Details

I. General information

NPI: 1558917971
Provider Name (Legal Business Name): ALEXANDRA MICHELLE BRIDGES M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 DRUID RD E APT 301
CLEARWATER FL
33756-4055
US

IV. Provider business mailing address

1121 DRUID RD E APT 301
CLEARWATER FL
33756-4055
US

V. Phone/Fax

Practice location:
  • Phone: 443-841-4281
  • Fax:
Mailing address:
  • Phone: 443-841-4281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number09401
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA24693
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: