Provider Demographics
NPI:1841394376
Name:MALONEY, ALEXIS (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 PALM SPRINGS DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7838
Mailing Address - Country:US
Mailing Address - Phone:407-389-1092
Mailing Address - Fax:407-389-1097
Practice Address - Street 1:652 PALM SPRINGS DRIVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7838
Practice Address - Country:US
Practice Address - Phone:407-389-1092
Practice Address - Fax:407-389-1097
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11722225X00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist