Provider Information for 1851527782
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ALEXANDRA JOAN CONNOR
Sex: Female
NPI: 1851527782
Last Updated: 2020-01-17
Certification Date: 2020-01-17
Certification Date: 2020-01-17
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1851527782 | ||||||||||||
| Enumeration Date | 2009-06-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3577 SW CORPORATE PKWY PALM CITY, FL 34990-8153 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 3577 SW CORPORATE PKWY PALM CITY, FL 34990-8153 United States Phone: 772-220-3439 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 6425 W 12TH ST | ||||||||||||
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