Individual
ALEJANDRO JOSE LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1703 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1221
(850) 864-4033
Mailing address
PO BOX 3413, INDIANAPOLIS, IN 46206-3413
(850) 864-4033
(850) 864-4076
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18181
SD
208600000X
Surgery Physician
Primary
LL 29082
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530217
—
TN
05
—
290820
—
SC
Enumeration date
05/31/2007
Last updated
02/15/2026
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