Provider Demographics
NPI:1497208318
Name:ALEXANDER, DAVID ALLEN (COTA-L)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:COTA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 RAINBOW SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7781
Mailing Address - Country:US
Mailing Address - Phone:407-516-3383
Mailing Address - Fax:
Practice Address - Street 1:2750 RAINBOW SPRINGS LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7781
Practice Address - Country:US
Practice Address - Phone:407-516-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10785224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant