Healthcare Provider Details

I. General information

NPI: 1790574622
Provider Name (Legal Business Name): ALEXANDRE NEUROSCIENCE CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 PALM BEACH LAKES BLVD STE 100
WEST PALM BEACH FL
33409-6500
US

IV. Provider business mailing address

2047 PALM BEACH LAKES BLVD STE 100
WEST PALM BEACH FL
33409-6500
US

V. Phone/Fax

Practice location:
  • Phone: 516-507-0800
  • Fax: 516-507-0800
Mailing address:
  • Phone: 516-507-0800
  • Fax: 516-507-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CARIANNE YANTZ
Title or Position: ADMIN
Credential:
Phone: 516-507-0800