Provider Demographics
NPI:1386635290
Name:CASLER, ALIX G (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIX
Middle Name:G
Last Name:CASLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9679 LAKE NONA VILLAGE PL STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7310
Mailing Address - Country:US
Mailing Address - Phone:407-261-2934
Mailing Address - Fax:407-636-7811
Practice Address - Street 1:9679 LAKE NONA VILLAGE PL STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7310
Practice Address - Country:US
Practice Address - Phone:407-261-2934
Practice Address - Fax:407-636-7811
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63270208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265547100Medicaid
E20147Medicare UPIN