Healthcare Provider Details

I. General information

NPI: 1972131563
Provider Name (Legal Business Name): ALEX SPEER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E BURGESS RD
PENSACOLA FL
32504-7001
US

IV. Provider business mailing address

6160 N DAVIS HWY STE 1
PENSACOLA FL
32504-6967
US

V. Phone/Fax

Practice location:
  • Phone: 850-806-2153
  • Fax: 850-806-2153
Mailing address:
  • Phone: 850-476-2805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPENDING
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4564
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: