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General NPI Number Information
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NPI Number | 1205415585
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Entity Type | Individual
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Provider Name | JEAN JUDE ALEXIS APRN
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Gender | Male
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 07/06/2024
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Provider Practice Location Address
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Address Line | 120 BENCHLEY PL FRNT 2
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City | BRONX
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State | NY
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Zip | 10475-3402
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Country | US
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Telephone | 347-843-7760
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Fax | 347-843-7780
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Provider Business Mailing Address
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Address Line | 6415 LAKE WORTH RD STE 207
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City | GREENACRES
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State | FL
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Zip | 33463-2904
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Country | US
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Telephone | 613-288-4205
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Fax | 561-828-2884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405853
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP11013685
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License Number State | FL
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