Provider Demographics
NPI:1386172682
Name:COREY, ALEX VEZINA
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:VEZINA
Last Name:COREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:MICHELLE
Other - Last Name:VEZINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2995 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:400 PINELLAS ST STE 400
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-462-3401
Practice Address - Fax:727-533-5994
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME163158207V00000X
MI4301505195207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology