Healthcare Provider Details

I. General information

NPI: 1134040678
Provider Name (Legal Business Name): ALEXANDRA RAE MEREDITH PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 W ATLANTIC AVE UNIT 101
DELRAY BEACH FL
33445-3838
US

IV. Provider business mailing address

2416 SW 6TH CT
FORT LAUDERDALE FL
33312-2268
US

V. Phone/Fax

Practice location:
  • Phone: 617-794-5956
  • Fax:
Mailing address:
  • Phone: 617-794-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: