Provider Demographics
NPI:1104384999
Name:ALEXANDRE, JOEL DORCE (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:DORCE
Last Name:ALEXANDRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SW GARNET ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-1406
Mailing Address - Country:US
Mailing Address - Phone:318-541-9390
Mailing Address - Fax:
Practice Address - Street 1:1362 SW BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2929
Practice Address - Country:US
Practice Address - Phone:772-873-5213
Practice Address - Fax:772-873-5215
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine