Provider Demographics
NPI:1477609394
Name:ZUBROD, ALEXIS RAQUEPAU (PH D)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:RAQUEPAU
Last Name:ZUBROD
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 COQUINA KEY DR SE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-4115
Mailing Address - Country:US
Mailing Address - Phone:727-481-8101
Mailing Address - Fax:
Practice Address - Street 1:926 16TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1211
Practice Address - Country:US
Practice Address - Phone:727-238-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 6234103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical