Provider Demographics
NPI:1396134995
Name:AGPASA, ALEX
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:AGPASA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12124 HIGH TECH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-8373
Mailing Address - Country:US
Mailing Address - Phone:180-077-4778
Mailing Address - Fax:
Practice Address - Street 1:1002 W FREMONT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3031
Practice Address - Country:US
Practice Address - Phone:408-739-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410722251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics