Provider Demographics
NPI:1467440842
Name:ALEXANDER, MICHAEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7390 NW 5TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1610
Mailing Address - Country:US
Mailing Address - Phone:954-424-9300
Mailing Address - Fax:954-424-3315
Practice Address - Street 1:7390 NW 5TH ST
Practice Address - Street 2:SUIITE 3
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1610
Practice Address - Country:US
Practice Address - Phone:954-424-9300
Practice Address - Fax:954-424-3315
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2014-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0040710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94172XOtherMEDICARE PTAN
FLD63142Medicare UPIN