Provider Demographics
NPI:1861157125
Name:ALEXIS, NAHOMIE
Entity type:Individual
Prefix:
First Name:NAHOMIE
Middle Name:
Last Name:ALEXIS
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 1:6412 N UNIVERSITY DR STE 114
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4002
Mailing Address - Country:US
Mailing Address - Phone:954-726-6722
Mailing Address - Fax:954-726-6723
Practice Address - Street 1:6412 N UNIVERSITY DR STE 114
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4002
Practice Address - Country:US
Practice Address - Phone:954-726-6722
Practice Address - Fax:954-726-6723
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care