Healthcare Provider Details

I. General information

NPI: 1235076423
Provider Name (Legal Business Name): ALEXIS LEMUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22651 SW 131ST AVE
MIAMI FL
33170-2772
US

IV. Provider business mailing address

22651 SW 131ST AVE
MIAMI FL
33170-2772
US

V. Phone/Fax

Practice location:
  • Phone: 305-215-4651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11046161
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: