Healthcare Provider Details

I. General information

NPI: 1467854521
Provider Name (Legal Business Name): JACQUES FERES ALEXIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2014
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NW 170TH ST
NORTH MIAMI BEACH FL
33169-5576
US

IV. Provider business mailing address

2379 NW 33RD TERRACE
COCONUT CREEK FL
33066-5283
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-1100
  • Fax:
Mailing address:
  • Phone: 786-541-7470
  • Fax: 859-301-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTRN29893
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57108
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number57108
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9366348
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9366348
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME153714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: