Healthcare Provider Details

I. General information

NPI: 1487365672
Provider Name (Legal Business Name): ALEXANDRA ROFFE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 NW 52ND ST
MIAMI FL
33166-4845
US

IV. Provider business mailing address

10631 SW 146TH PL
MIAMI FL
33186-2971
US

V. Phone/Fax

Practice location:
  • Phone: 305-559-8838
  • Fax: 305-559-6608
Mailing address:
  • Phone: 305-763-2338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH23335
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: