Organization Active NPI

Alexandra Victoria PSYD Inc

  • Clinical Psychologist
  • Weston, FL
National Provider Identifier
1265249031
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ALEXANDRA VICTORIA PSYD INC
Practice address
2200 N Commerce Pkwy Ste 200
Weston, FL 33326-3258
Phone
(954) 245-4464
NPI assigned
Dec 16, 2024
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Alexandra Victoria, PSYDNPI 1700509205
Title
Owner
Phone
(954) 245-4464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2200 N Commerce Pkwy Ste 200
Weston, FL 33326-3258

Mailing address

222 Lakeside Cir
Sunrise, FL 33326-2172
Phone (954) 245-4464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250103000079 FL Part B Supplier - Clinic/Group Practice 6608303680 Receives reassigned benefits from 1 practitioner
Practice locations: Weston, FL

National Provider Directory

National Provider Directory

Locations

2200 N Commerce Pkwy
Ste 200
Weston, FL 33326
Phone (305) 898-9707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1265249031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 LAKESIDE CIR",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333262172",
            "telephone_number": "954-245-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N COMMERCE PKWY STE 200",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263258",
            "telephone_number": "954-245-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRA VICTORIA PSYD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "VICTORIA",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-245-4464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.