Healthcare Provider Details

I. General information

NPI: 1760115638
Provider Name (Legal Business Name): ALEXANDRA DAVIS PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 N ATLANTIC AVE
COCOA BEACH FL
32931-5213
US

IV. Provider business mailing address

318 AVIATION AVE NE
PALM BAY FL
32907-1928
US

V. Phone/Fax

Practice location:
  • Phone: 321-222-6189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY12435
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY12435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: