Provider Demographics
NPI:1679326722
Name:MCCLAIN, ALEC (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 SW 127TH AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1468
Mailing Address - Country:US
Mailing Address - Phone:513-332-6921
Mailing Address - Fax:
Practice Address - Street 1:9415 SUNSET DR STE 111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5492
Practice Address - Country:US
Practice Address - Phone:786-507-8278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist