Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A7006 | CA |
Y | 207Q00000X | Family Doctor | OS16118 | FL |
NPI | 1003846510 |
---|---|
Provider Name | Dr. Brooke E Alexander |
First Address | The Villages, FL 32159-6827 |
Second Address | The Villages, FL 32159-6827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G99841 | (02) | |
MX195 | MEDICARE (01) | |
OS16118 | STATE LICENSE (01) | FL |