Provider Demographics
NPI:1255990867
Name:FERDINAND, ALIX SIMONE (MD)
Entity type:Individual
Prefix:
First Name:ALIX
Middle Name:SIMONE
Last Name:FERDINAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALIX
Other - Middle Name:SIMONE
Other - Last Name:PIJEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:738 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4917
Mailing Address - Country:US
Mailing Address - Phone:678-923-4458
Mailing Address - Fax:
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-938-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT220463208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice