Basic Information
| Provider Information | |||||||||
| NPI: | 1962907543 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDRE | ||||||||
| FirstName: | LOUVEDOR | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | ABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1037 MADDOCK ST E | ||||||||
| Address2: | |||||||||
| City: | LEHIGH ACRES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339745535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8558326727 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1037 MADDOCK ST. E | ||||||||
| Address2: | |||||||||
| City: | LEHIGH ACRES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33974 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2398980305 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2018 | ||||||||
| LastUpdateDate: | 03/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.