Healthcare Provider Details

I. General information

NPI: 1356152516
Provider Name (Legal Business Name): ALEJANDRA MARIE PASCUAL MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 E. 13 ST.
ST CLOUD FL
34769-4779
US

IV. Provider business mailing address

13979 OSPREY LINKS RD
ORLANDO FL
32837-4835
US

V. Phone/Fax

Practice location:
  • Phone: 407-749-3580
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: