Provider Demographics
NPI:1588019756
Name:JABEA, ALEXANDRE
Entity Type:Individual
Prefix:MR
First Name:ALEXANDRE
Middle Name:
Last Name:JABEA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 MOUNT PISGAH LN APT 13
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2152
Mailing Address - Country:US
Mailing Address - Phone:240-614-1384
Mailing Address - Fax:
Practice Address - Street 1:1809 MOUNT PISGAH LN APT 13
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2152
Practice Address - Country:US
Practice Address - Phone:240-614-1384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver
No374700000XNursing Service Related ProvidersTechnician