Provider Demographics
NPI:1669751723
Name:ALEXANDER, SARA DONOVAN (DC)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:DONOVAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:DONOVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1290 NW LAKESIDE TRL
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9509
Mailing Address - Country:US
Mailing Address - Phone:772-530-4028
Mailing Address - Fax:772-232-6068
Practice Address - Street 1:1807 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-7204
Practice Address - Country:US
Practice Address - Phone:772-286-6260
Practice Address - Fax:772-286-6912
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor