Healthcare Provider Details

I. General information

NPI: 1073557054
Provider Name (Legal Business Name): ALEXANDRA DUNN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 HOLLYWOOD BLVD SUITE 424
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

PO BOX 406153
ATLANTA GA
30384-1876
US

V. Phone/Fax

Practice location:
  • Phone: 561-451-3626
  • Fax: 561-451-0569
Mailing address:
  • Phone: 561-478-8770
  • Fax: 561-688-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1171
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: