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General NPI Number Information
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NPI Number | 1629894985
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Entity Type | Individual
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Provider Name | MR. ALEXANDER JULIAN CORDE
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Gender | Male
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 8725 HENDERSON RD
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City | TAMPA
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State | FL
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Zip | 33634-1143
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Country | US
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Telephone | 727-777-9352
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Fax |
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Provider Business Mailing Address
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Address Line | 18321 SNOWDONIA DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-7963
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Country | US
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Telephone | 727-777-9352
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW23853
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License Number State | FL
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