Provider Demographics
NPI:1205904455
Name:PARKER, ALEXA M (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 HENDERSON BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5657
Mailing Address - Country:US
Mailing Address - Phone:813-254-5200
Mailing Address - Fax:813-254-5278
Practice Address - Street 1:4343 HENDERSON BLVD STE 180
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5657
Practice Address - Country:US
Practice Address - Phone:813-254-5200
Practice Address - Fax:813-254-5278
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM16162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89673AMedicare ID - Type Unspecified