MEDICARE: DR. ALEXANDRA LOUISELIE JOSEPH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	071792	GA
2	207R00000X	Internal Medicine Physician	MD.207728	LA
3	207RC0000X	Cardiovascular Disease Physician	ME121635	FL

General Provider Information

NPI Number	:	1366732414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA LOUISELIE JOSEPH M.D.

Provider Business Mailing Address
First Line	:	1370 E VENICE AVE STE 102
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34285-9083
Country	:	US
Telephone Number	:	941-412-0026
Fax Number	:	941-412-0027

Provider Business Practice Location Address
First Line	:	1370 E VENICE AVE STE 102
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34285-9083
Country	:	US
Telephone Number	:	941-412-0026
Fax Number	:	941-412-0027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2011
Last Update Date	:	09/04/2024

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