Provider Demographics
NPI:1154437184
Name:ALEXANDER, LINDA LOUISE (DPM)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LOUISE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2376 FOXHAVEN DR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-2010
Mailing Address - Country:US
Mailing Address - Phone:904-221-3224
Mailing Address - Fax:904-220-0929
Practice Address - Street 1:1361 13TH AVE S STE 120
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3260
Practice Address - Country:US
Practice Address - Phone:904-241-2655
Practice Address - Fax:904-249-2425
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 0002222213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU22788Medicare UPIN
FL65207Medicare ID - Type Unspecified