Provider Demographics
NPI:1982463444
Name:MUNOZ TORRES, ALEXSA LUCIA
Entity Type:Individual
Prefix:
First Name:ALEXSA
Middle Name:LUCIA
Last Name:MUNOZ TORRES
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 1:1209 S KIRKMAN RD APT 2130
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2213
Mailing Address - Country:US
Mailing Address - Phone:703-340-0263
Mailing Address - Fax:
Practice Address - Street 1:1209 S KIRKMAN RD APT 2130
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-2213
Practice Address - Country:US
Practice Address - Phone:703-340-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-336483106S00000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician