Provider Demographics
NPI:1154914596
Name:ALPHA PHYSICAL THERAPY CLINIC INC
Entity type:Organization
Organization Name:ALPHA PHYSICAL THERAPY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HANY MONGUI
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAWADROUS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:321-690-1223
Mailing Address - Street 1:147 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2801
Mailing Address - Country:US
Mailing Address - Phone:321-690-1220
Mailing Address - Fax:321-690-1223
Practice Address - Street 1:147 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2801
Practice Address - Country:US
Practice Address - Phone:321-690-1220
Practice Address - Fax:321-690-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation