Provider Demographics
NPI:1457911232
Name:ALEXANDER, JERNEL LEISA (RRT)
Entity Type:Individual
Prefix:MS
First Name:JERNEL
Middle Name:LEISA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NE 135TH ST APT 311
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2101
Mailing Address - Country:US
Mailing Address - Phone:954-380-1004
Mailing Address - Fax:
Practice Address - Street 1:2000 NE 135TH ST APT 311
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2101
Practice Address - Country:US
Practice Address - Phone:954-380-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT11566227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered