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Individual

DR. ALEXANDER DEJESUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6400 EDGELAKE DR, SARASOTA, FL 34240-8813
(941) 921-8645
Mailing address
PO BOX 4898, WINTER PARK, FL 32793-4898
(407) 681-2241

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME0077137
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
250011263
RR MEDICARE
FL
05
258701700
FL
01
44664
BCBS
FL
Enumeration date
01/08/2007
Last updated
07/14/2022
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