Healthcare Provider Details

I. General information

NPI: 1255080305
Provider Name (Legal Business Name): KATY ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 SE 31ST ST UNIT 3
OCALA FL
34471-0741
US

IV. Provider business mailing address

1379 PLAYERS CLUB CIR
GULF BREEZE FL
32563-3521
US

V. Phone/Fax

Practice location:
  • Phone: 775-367-6937
  • Fax:
Mailing address:
  • Phone: 352-533-5884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: