Provider Demographics
NPI:1588371231
Name:INCERA-GARCIA, ALEXIA (DPT)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:INCERA-GARCIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXIA
Other - Middle Name:
Other - Last Name:INCERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5863 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5311
Mailing Address - Country:US
Mailing Address - Phone:305-608-4517
Mailing Address - Fax:
Practice Address - Street 1:145 MADEIRA AVE STE 206
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4520
Practice Address - Country:US
Practice Address - Phone:305-608-4517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist