Provider Demographics
NPI:1831838119
Name:DELEON, ALEXIS HALEIGH
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:HALEIGH
Last Name:DELEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:HALEIGH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1154 DAMEN ST E
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-4792
Mailing Address - Country:US
Mailing Address - Phone:239-478-1113
Mailing Address - Fax:
Practice Address - Street 1:1154 DAMEN ST E
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33974-4792
Practice Address - Country:US
Practice Address - Phone:239-478-1113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty