Provider Demographics
NPI:1578233623
Name:BAYER, ALEXA MARIE
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:BAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10044 NEAMATHLA TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-9681
Mailing Address - Country:US
Mailing Address - Phone:850-339-9882
Mailing Address - Fax:
Practice Address - Street 1:10044 NEAMATHLA TRL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-9681
Practice Address - Country:US
Practice Address - Phone:850-339-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17090224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant