Provider Demographics
NPI:1215215843
Name:RESNICK, ALEXIS (PHD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:RESNICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S PINE ISLAND RD STE 226
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2631
Mailing Address - Country:US
Mailing Address - Phone:305-771-1522
Mailing Address - Fax:954-734-9395
Practice Address - Street 1:300 S PINE ISLAND RD STE 226
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2631
Practice Address - Country:US
Practice Address - Phone:305-771-1522
Practice Address - Fax:954-734-9395
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8829103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical