Individual
ALEXANDER HOFSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 E IRLO BRONSON MEMORIAL HWY STE 8, KISSIMMEE, FL 34744-4411
(407) 483-7497
Mailing address
12389 ANTONIO CIR, ORLANDO, FL 32826-3295
(407) 373-4110
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB668996
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110388900
—
FL
Enumeration date
06/17/2021
Last updated
06/17/2021
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