Provider Demographics
NPI:1922423797
Name:MARRERO, ALLEXELENA
Entity Type:Individual
Prefix:
First Name:ALLEXELENA
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 MILLENNIUM PKWY
Mailing Address - Street 2:SUITE #104
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-3879
Mailing Address - Country:US
Mailing Address - Phone:813-409-0435
Mailing Address - Fax:
Practice Address - Street 1:1219 MILLENNIUM PKWY
Practice Address - Street 2:SUITE #104
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-3879
Practice Address - Country:US
Practice Address - Phone:813-409-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist