Individual
DOUBER ALTIDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0915
(813) 978-9700
(813) 558-6185
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0915
(813) 978-9700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA32246
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA32246
LICENSE
FL
Enumeration date
10/24/2022
Last updated
10/25/2022
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