Provider Demographics
NPI:1033551163
Name:VIVAS, ALEJANDRA CAROLINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRA
Middle Name:CAROLINA
Last Name:VIVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN
Mailing Address - Street 2:STE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:1951 SW 172ND AVE
Practice Address - Street 2:416
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5593
Practice Address - Country:US
Practice Address - Phone:954-447-3200
Practice Address - Fax:954-447-3205
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME128624207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology