Healthcare Provider Details

I. General information

NPI: 1053232538
Provider Name (Legal Business Name): ALEXCIS SHELTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 N GOLDENROD RD
WINTER PARK FL
32792-8823
US

IV. Provider business mailing address

6969 ALOMA AVE APT 124
WINTER PARK FL
32792-7059
US

V. Phone/Fax

Practice location:
  • Phone: 407-516-7918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: