Healthcare Provider Details

I. General information

NPI: 1063182228
Provider Name (Legal Business Name): ALEXENDRA LEVINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 W 84TH ST
HIALEAH FL
33014-3363
US

IV. Provider business mailing address

17650 NW 82ND CT
HIALEAH FL
33015-3613
US

V. Phone/Fax

Practice location:
  • Phone: 305-828-5276
  • Fax:
Mailing address:
  • Phone: 786-202-6630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: