MEDICARE: LEEWENSKY 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	106E00000X	Assistant Behavior Analyst	4254	FL
2	106E00000X	Assistant Behavior Analyst	45	FL
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1659142859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEEWENSKY ALEXANDER

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12114 MAGAZINE ST APT 3210
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-5536
Country	:	US
Telephone Number	:	772-607-4693
Fax Number	:

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

Provider Enumeration Date	:	01/16/2024
Last Update Date	:	05/14/2025

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Directions to “ LEEWENSKY ALEXANDER ” Practice Location

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