Alexander Simon Stephen Maddock

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

43213 Issued in FL

Practice address

1611 NW 12TH Ave
Miami, FL 33136-1005

Phone

(305) 585-6000

NPI assigned

Apr 8, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1427801844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985023",
            "country_code": "US",
            "telephone_number": "804-828-8786",
            "fax_number": "804-828-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDOCK",
        "first_name": "ALEXANDER",
        "middle_name": "SIMON STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "43213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth J Macy
• Brianna Maczon-Campos
• Krisstina Madan, ARNP
• Maria Elena Madan, RPH
• Solanch Madan
• Madison Maddox
• Carmelo Maddy
• Madel Pharmacy, Corp
• Madeleine Rodriguez-Alonso MD PA
• Madelin Home Care Corp

• Student in an Organized Health Care Education/Training Program in Miami, FL
• Providers in Miami, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.