Provider Demographics
NPI:1457334757
Name:WU CHAVEZ, ALEXA MILAGROS (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:MILAGROS
Last Name:WU CHAVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEXA
Other - Middle Name:MILAGROS
Other - Last Name:WU-CHAVEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:689-223-3898
Mailing Address - Fax:689-223-3898
Practice Address - Street 1:4160 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4317
Practice Address - Country:US
Practice Address - Phone:904-861-1900
Practice Address - Fax:904-292-9264
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16166208D00000X
FLACN960208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice