Provider Demographics
NPI:1720423932
Name:HONIGBAUM, ALEXIS B (MD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:B
Last Name:HONIGBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7995 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2163
Mailing Address - Country:US
Mailing Address - Phone:727-530-0920
Mailing Address - Fax:727-827-7139
Practice Address - Street 1:7995 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2163
Practice Address - Country:US
Practice Address - Phone:727-530-0920
Practice Address - Fax:727-827-7139
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME140353207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110176500Medicaid