Individual
DR. ALEXANDER FERNANDO SAN DIEGO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2404 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4191
(321) 452-1327
(321) 454-9208
Mailing address
2404 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4191
(321) 452-1327
(321) 454-9208
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3686
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053678052
NPI
—
01
—
13574563
CAQH
—
Enumeration date
04/13/2012
Last updated
08/24/2015
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