Provider Demographics
NPI:1740061795
Name:ALEXANDER, VICTORIA
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5261 ALHAMBRA DR APT 15
Mailing Address - Street 2:
Mailing Address - City:PINE HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:32808-7244
Mailing Address - Country:US
Mailing Address - Phone:904-521-2610
Mailing Address - Fax:
Practice Address - Street 1:730 SAND LAKE RD STE 176
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7747
Practice Address - Country:US
Practice Address - Phone:407-368-9942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT23301433106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician