Individual
ELENA B. ALEXIEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
18070 S. TAMIAMI TRAIL, #101, FORT MYERS, FL 33908
(239) 236-4820
Mailing address
6766 WILLOW LAKE CIRCLE, FORT MYERS, FL 33966
(941) 268-8391
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00203330
CO
122300000X
Dentist
Primary
DN21697
FL
1223G0001X
General Practice Dentistry
DN21697
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/13/2015
Last updated
09/05/2018
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