Individual
ALEXANDRA MALEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 COMMERCIAL CT STE C, VENICE, FL 34292-1655
(900) 356-4049
(800) 895-0648
Mailing address
10014 N DALE MABRY HWY STE C-100, TAMPA, FL 33618-4426
(800) 356-4049
(800) 892-0648
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106S00000X
—
FL
Enumeration date
10/10/2018
Last updated
10/10/2018
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