MEDICARE: NEKELE ALEXIS

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	106S00000X	Behavior Technician	RBT-20-115481	FL

General Provider Information

NPI Number	:	1700412335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEKELE ALEXIS

Provider Business Mailing Address
First Line	:	7151 CHESAPEAKE CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-8570
Country	:	US
Telephone Number	:	561-634-5339
Fax Number	:

Provider Business Practice Location Address
First Line	:	7151 CHESAPEAKE CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-8570
Country	:	US
Telephone Number	:	561-634-5339
Fax Number	:

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

Provider Enumeration Date	:	03/16/2020
Last Update Date	:	03/16/2020

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Directions to “ NEKELE ALEXIS ” Practice Location

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