MEDICARE: ALEXA MEDICAL SUPPLY CORPORATION

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	332B00000X	Durable Medical Equipment & Medical Supplies	P01000065637	FL

General Provider Information

NPI Number	:	1801849013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXA MEDICAL SUPPLY CORPORATION

Provider Business Mailing Address
First Line	:	610 W LAS OLAS BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-7141
Country	:	US
Telephone Number	:	561-706-6679
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 W LAS OLAS BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-7141
Country	:	US
Telephone Number	:	561-706-6679
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. KIMBERLY ANNE SILVERSTEIN
Credential	:
Telephone Number	:	561-706-6679

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	08/22/2020

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