Healthcare Provider Details

I. General information

NPI: 1871225615
Provider Name (Legal Business Name): ALEXANDRIA PAIGE GUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 W PIPKIN RD
LAKELAND FL
33813-2545
US

IV. Provider business mailing address

1123 85TH TER N APT A
SAINT PETERSBURG FL
33702-3312
US

V. Phone/Fax

Practice location:
  • Phone: 863-619-2809
  • Fax:
Mailing address:
  • Phone: 910-890-9451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2858191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: