Provider Demographics
NPI:1407925688
Name:ALEXANDER, LAUREN F (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:F
Last Name:ALEXANDER
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 1:4500 SAN PABLO RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1865
Mailing Address - Country:US
Mailing Address - Phone:904-953-2000
Mailing Address - Fax:
Practice Address - Street 1:4500 SAN PABLO RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1865
Practice Address - Country:US
Practice Address - Phone:904-953-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL295292085R0202X
FLME1105322085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051599143OtherBCBS
AL051599158OtherBCBS
P00816143OtherRAILROAD MEDICARE
AL051599154OtherBCBS
AL051599160OtherBCBS
MS07727339Medicaid
AL051599158OtherBCBS
AL051599160OtherBCBS
AL111789Medicaid
AL111797Medicaid
AL111800Medicaid
P00816143OtherRAILROAD MEDICARE
AL051599143OtherBCBS
AL111788Medicaid
AL111799Medicaid
AL111798Medicaid
P00816143OtherRAILROAD MEDICARE
AL051599143OtherBCBS
102I308683Medicare UPIN
AL051599153Medicare UPIN
AL111801Medicaid
AL111788Medicaid