Healthcare Provider Details

I. General information

NPI: 1437988045
Provider Name (Legal Business Name): ALEXIA CONSTANTINIDES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 NW 56TH TER
GAINESVILLE FL
32605-4481
US

IV. Provider business mailing address

1000 SW 62ND BLVD APT 1032
GAINESVILLE FL
32607-5902
US

V. Phone/Fax

Practice location:
  • Phone: 352-835-5520
  • Fax:
Mailing address:
  • Phone: 516-406-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: