Individual
MR. ALEX ANDRE FELICIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4809 ASHLAND AVE APT A, LORAIN, OH 44053-3162
(407) 724-2973
Mailing address
4809 ASHLAND AVE APT A, LORAIN, OH 44053-3162
(407) 724-2973
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
4705930
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0403036
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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