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NPI Code Detail

MEDICARE: ALEXANDRA HEALTHCARE, LLC

MEDICARE: ALEXANDRA HEALTHCARE, LLC
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
1111N00000XChiropractorCH4743FL

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 : 1871594119
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEXANDRA HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 110 N KIRKMAN RD
Second Line :
City : ORLANDO
State : FL
Zip : 32811-1404
Country : US
Telephone Number : 407-291-1000
Fax Number : 407-291-2538
Provider Business Practice Location Address
First Line : 110 N KIRKMAN RD
Second Line :
City : ORLANDO
State : FL
Zip : 32811-1404
Country : US
Telephone Number : 407-291-1000
Fax Number : 407-291-2538
Authorized Official
Title or Position : OWNER
Name : DR. GARY STUART GROSSMAN
Credential : DC
Telephone Number : 407-291-1000
Provider Enumeration Date : 08/09/2005
Last Update Date : 10/28/2011

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Directions to “ALEXANDRA HEALTHCARE, LLC ” Practice Location

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