Provider Demographics
NPI:1679113658
Name:DURON, ALEXIS K (OTD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:K
Last Name:DURON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12615 ADVENTURE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7791
Mailing Address - Country:US
Mailing Address - Phone:805-657-6206
Mailing Address - Fax:
Practice Address - Street 1:12615 ADVENTURE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7791
Practice Address - Country:US
Practice Address - Phone:805-657-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20581225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist