Provider Demographics
NPI:1659119568
Name:MULL, ALEXANDER
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:MULL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12525 NE 13TH AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5131
Mailing Address - Country:US
Mailing Address - Phone:765-586-9193
Mailing Address - Fax:
Practice Address - Street 1:3735 SW 8TH ST STE 201
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3161
Practice Address - Country:US
Practice Address - Phone:305-200-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty