MEDICARE: ALEXANDRA JOAN CONNOR

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
2	1041C0700X	Clinical Social Worker	SW16802	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1851527782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA JOAN CONNOR

Provider Business Mailing Address
First Line	:	3577 SW CORPORATE PKWY
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-8153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3577 SW CORPORATE PKWY
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-8153
Country	:	US
Telephone Number	:	772-220-3439
Fax Number	:

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

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	01/17/2020

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