Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME60736 | FL |
NPI | 1659363836 |
---|---|
Provider Name | Dr. Raquelle Alexander |
First Address | St Petersburg, FL 33733-2868 |
Second Address | St Petersburg, FL 33705-1407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 28/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
252689100 | (05) | FL |
F79148 | (02) | FL |