Individual
MR. ALEXANDER RIESGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
15623 SW 36TH TER, MIAMI, FL 33185-4790
(786) 709-5083
Mailing address
15623 SW 36TH TER, MIAMI, FL 33185-4790
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23681
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 23681
OTHER
FL
Enumeration date
05/16/2013
Last updated
05/16/2013
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