Healthcare Provider Details

I. General information

NPI: 1780468892
Provider Name (Legal Business Name): ALEXANDRA SKORNIA SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 W SUNRISE BLVD STE 107
SUNRISE FL
33323-3207
US

IV. Provider business mailing address

6604 S ANISE CT
DAVIE FL
33314-3918
US

V. Phone/Fax

Practice location:
  • Phone: 954-756-2818
  • Fax: 954-514-1126
Mailing address:
  • Phone: 954-678-7392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA22780
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: