Healthcare Provider Details

I. General information

NPI: 1285628255
Provider Name (Legal Business Name): ALEXANDER KECHRIOTIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 S EAST AVE SUITE 306
SARASOTA FL
34239-2340
US

IV. Provider business mailing address

1219 S EAST AVE SUITE 306
SARASOTA FL
34239-2340
US

V. Phone/Fax

Practice location:
  • Phone: 941-363-9100
  • Fax: 941-363-9103
Mailing address:
  • Phone: 941-363-9100
  • Fax: 941-363-9103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME70697
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: