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NPI Code Detail

MEDICARE: ALEXIS KINLOCH

MEDICARE: ALEXIS KINLOCH
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
1363A00000XPhysician AssistantPA9111937FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497212401
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS KINLOCH
Provider Business Mailing Address
First Line : 11946 ARBOR LAKE DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-7609
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5818 S DIXIE HWY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33405-3608
Country : US
Telephone Number : 561-429-4779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2019
Last Update Date : 03/12/2019

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Directions to “ ALEXIS KINLOCH ” Practice Location

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