Provider Demographics
NPI:1225410350
Name:CAREW, ALEXIA
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:CAREW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 S APOLLO BLVD
Mailing Address - Street 2:STE. 104
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1402
Mailing Address - Country:US
Mailing Address - Phone:321-432-2572
Mailing Address - Fax:321-768-2489
Practice Address - Street 1:780 S APOLLO BLVD
Practice Address - Street 2:STE. 103
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1402
Practice Address - Country:US
Practice Address - Phone:321-432-2572
Practice Address - Fax:321-768-2489
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 7109235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ 7109OtherPROVISIONAL LICENSE NUMBER