Provider Demographics
NPI:1548857477
Name:ALEXIS, STEVENSON (OTR/L)
Entity type:Individual
Prefix:MR
First Name:STEVENSON
Middle Name:
Last Name:ALEXIS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7431 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5320
Mailing Address - Country:US
Mailing Address - Phone:786-873-8057
Mailing Address - Fax:
Practice Address - Street 1:7431 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-5320
Practice Address - Country:US
Practice Address - Phone:786-873-8057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21441225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist