Provider Demographics
NPI:1942821343
Name:PELAEZ, ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:PELAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BERRY LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-6204
Mailing Address - Country:US
Mailing Address - Phone:516-450-7139
Mailing Address - Fax:
Practice Address - Street 1:133 BENMORE DR STE 201
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4111
Practice Address - Country:US
Practice Address - Phone:407-646-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program