Provider Demographics
NPI:1225080518
Name:ALEX, STEPHEN
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:ALEX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6705 SW 57TH AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3638
Mailing Address - Country:US
Mailing Address - Phone:305-476-1182
Mailing Address - Fax:305-476-1091
Practice Address - Street 1:6705 SW 57TH AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3638
Practice Address - Country:US
Practice Address - Phone:305-476-1182
Practice Address - Fax:305-476-1091
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91409174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist