1710911367 NPI number — DR. JOSEPH RICHARD ALEXANDER D.O.

Table of content: DR. JOSEPH RICHARD ALEXANDER D.O. (NPI 1710911367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710911367 NPI number — DR. JOSEPH RICHARD ALEXANDER D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDER
Provider First Name:
JOSEPH
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710911367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16102 EMERALD ESTATES DR
Provider Second Line Business Mailing Address:
APT. 236
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33331-6100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-217-3906
Provider Business Mailing Address Fax Number:
954-217-3906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 N.W. 12TH AVE
Provider Second Line Business Practice Location Address:
JACKSON MEMORIAL HOSPITAL, TAYLOR BREAST CENTER
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136-1096
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-585-7410
Provider Business Practice Location Address Fax Number:
305-585-0040
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  OS 9246 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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