Healthcare Provider Details

I. General information

NPI: 1780931808
Provider Name (Legal Business Name): DAVID ALEXANDER MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22790 SW 112TH AVE
MIAMI FL
33170-7602
US

IV. Provider business mailing address

22790 SW 112TH AVE
MIAMI FL
33170-7602
US

V. Phone/Fax

Practice location:
  • Phone: 305-235-2616
  • Fax: 305-235-6178
Mailing address:
  • Phone: 305-235-2616
  • Fax: 305-235-6178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: