Provider Demographics
NPI:1750341046
Name:LEYTE-VIDAL, ALEXANDER (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:LEYTE-VIDAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WINDSORMERE WAY
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6592
Mailing Address - Country:US
Mailing Address - Phone:407-971-4444
Mailing Address - Fax:407-971-6333
Practice Address - Street 1:35 WINDSORMERE WAY
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6592
Practice Address - Country:US
Practice Address - Phone:407-971-4444
Practice Address - Fax:407-971-6333
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-0014758122300000X
WI4806122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist