Healthcare Provider Details

I. General information

NPI: 1538714753
Provider Name (Legal Business Name): ALEXANDRA LEWIS CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ALEXANDRA LEWIS

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NW 35TH AVENUE RD
OCALA FL
34475-4630
US

IV. Provider business mailing address

PO BOX 100183
GAINESVILLE FL
32610-0183
US

V. Phone/Fax

Practice location:
  • Phone: 352-280-7400
  • Fax: 352-820-7401
Mailing address:
  • Phone: 352-392-0140
  • Fax: 352-392-8217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number100891
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME168747
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: