Provider Demographics
NPI:1447532965
Name:MONTOYA, ALEXANDRA KRISTAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:KRISTAL
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 CAMPHORWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4007
Mailing Address - Country:US
Mailing Address - Phone:407-596-7838
Mailing Address - Fax:
Practice Address - Street 1:2530 CAMPHORWOOD CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4007
Practice Address - Country:US
Practice Address - Phone:407-596-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist