Provider Demographics
NPI:1114351921
Name:HOMANN, ALEXANDRA SCHUETTE (OD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:SCHUETTE
Last Name:HOMANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:SCHUETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3200 S UNIVERSITY DR
Mailing Address - Street 2:TERRY BUILDING 1402
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2018
Mailing Address - Country:US
Mailing Address - Phone:954-262-1402
Mailing Address - Fax:954-262-3217
Practice Address - Street 1:230 N LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5904
Practice Address - Country:US
Practice Address - Phone:314-921-9377
Practice Address - Fax:314-921-9377
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002827152W00000X
FLOFC61152W00000X
MO2016005437152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist