Healthcare Provider Details

I. General information

NPI: 1447178355
Provider Name (Legal Business Name): ALEXIS PUENTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 OLDE WATERFORD WAY STE 205
LELAND NC
28451-4148
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 910-399-4039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15877
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: