Provider Demographics
NPI:1588135362
Name:STEVENS, ALISON LESLIE (ATC, LAT, SPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LESLIE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:ATC, LAT, SPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14142 SUNRIVER AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8251
Mailing Address - Country:US
Mailing Address - Phone:305-299-4675
Mailing Address - Fax:
Practice Address - Street 1:4000 CENTRAL FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-8005
Practice Address - Country:US
Practice Address - Phone:407-823-2408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL48222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer