Provider Demographics
NPI:1013705516
Name:BOWEN CRUZATI, ALEXANDRA G (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:G
Last Name:BOWEN CRUZATI
Suffix:
Gender:
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:G
Other - Last Name:BOWEN CRUZATI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1912 W LAKEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-6422
Mailing Address - Country:US
Mailing Address - Phone:239-645-1827
Mailing Address - Fax:
Practice Address - Street 1:1912 W LAKEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-6422
Practice Address - Country:US
Practice Address - Phone:239-645-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA86243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist