Provider Demographics
NPI:1619659653
Name:ALEXANDER, WYNDELL JR
Entity Type:Individual
Prefix:
First Name:WYNDELL
Middle Name:
Last Name:ALEXANDER
Suffix:JR
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 1:9109 E CHINA GROVE LN
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-8863
Mailing Address - Country:US
Mailing Address - Phone:352-445-6594
Mailing Address - Fax:
Practice Address - Street 1:110 S APOPKA AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4837
Practice Address - Country:US
Practice Address - Phone:352-560-7027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health