Provider Demographics
NPI:1639899453
Name:CANAS, ALEJANDRA ANDREA (OD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:ANDREA
Last Name:CANAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 SHOWER TREE WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5839
Mailing Address - Country:US
Mailing Address - Phone:561-346-3168
Mailing Address - Fax:
Practice Address - Street 1:1807 SHOWER TREE WAY
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-5839
Practice Address - Country:US
Practice Address - Phone:561-346-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003469152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist