Provider Demographics
NPI:1972959815
Name:ALEXANDER PHYSICAL THERAPY
Entity type:Organization
Organization Name:ALEXANDER PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIMBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-394-1000
Mailing Address - Street 1:10720 PARK BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-5461
Mailing Address - Country:US
Mailing Address - Phone:727-397-3000
Mailing Address - Fax:727-397-3004
Practice Address - Street 1:10720 PARK BLVD
Practice Address - Street 2:STE A
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-5461
Practice Address - Country:US
Practice Address - Phone:727-397-3000
Practice Address - Fax:727-397-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty