Provider Demographics
NPI:1699136325
Name:ALEXANDER, JIHAD (CNA)
Entity type:Individual
Prefix:
First Name:JIHAD
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 12TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8442
Mailing Address - Country:US
Mailing Address - Phone:941-545-9699
Mailing Address - Fax:
Practice Address - Street 1:813 12TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8442
Practice Address - Country:US
Practice Address - Phone:941-545-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA228057376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide