Healthcare Provider Details

I. General information

NPI: 1174389407
Provider Name (Legal Business Name): ALEXANDRA CAYCE OROPALLO MA, RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 S FISKE BLVD STE 201
ROCKLEDGE FL
32955-3007
US

IV. Provider business mailing address

1802 S FISKE BLVD STE 201
ROCKLEDGE FL
32955-3007
US

V. Phone/Fax

Practice location:
  • Phone: 321-446-2113
  • Fax:
Mailing address:
  • Phone: 321-446-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH25436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: