MEDICARE: MRS. TONYA LETISHA ALEXANDER

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1437335981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONYA LETISHA ALEXANDER

Provider Business Mailing Address
First Line	:	8814 OXFORDSHIRE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-4319
Country	:	US
Telephone Number	:	904-576-0950
Fax Number	:

Provider Business Practice Location Address
First Line	:	8814 OXFORDSHIRE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-4319
Country	:	US
Telephone Number	:	904-576-0950
Fax Number	:

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

Provider Enumeration Date	:	01/15/2008
Last Update Date	:	01/15/2008

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