Provider Demographics
NPI:1679103600
Name:ALEXANDER, KAREN GABRIELA (RND, LD/N)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:GABRIELA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RND, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9397 CUMBERLAND ISLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257
Mailing Address - Country:US
Mailing Address - Phone:904-250-2841
Mailing Address - Fax:
Practice Address - Street 1:ACKERMAN CANCER CENTER
Practice Address - Street 2:10881 SAN JOSE BLVD
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:904-880-5522
Practice Address - Fax:904-880-5533
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9486133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered