Provider Demographics
NPI:1952697625
Name:KEHOE, ALEXANDRA NICOLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:KEHOE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7840 GLADES RD
Mailing Address - Street 2:STE 245
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4102
Mailing Address - Country:US
Mailing Address - Phone:561-482-8300
Mailing Address - Fax:561-482-8381
Practice Address - Street 1:7045 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2205
Practice Address - Country:US
Practice Address - Phone:954-625-2388
Practice Address - Fax:954-625-2390
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002513152W00000X
FLOPC4614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist