Healthcare Provider Details

I. General information

NPI: 1720860745
Provider Name (Legal Business Name): ALEXANDRIA NOEL MAYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 SW 75TH ST STE B
GAINESVILLE FL
32607-3425
US

IV. Provider business mailing address

2823 SW 92ND TER
GAINESVILLE FL
32608-7986
US

V. Phone/Fax

Practice location:
  • Phone: 877-823-4283
  • Fax:
Mailing address:
  • Phone: 815-988-8029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number22-249750
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90177
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: