Individual
MRS. ALICIA A NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT BCB PMD
Contact information
Practice address
827 CYPRESS VILLAGE BLVD, RUSKIN, FL 33573-6838
(813) 633-0669
(813) 633-0881
Mailing address
3306 YELLOWKNIFE CIR, WIMAUMA, FL 33598-7126
(727) 776-5542
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8895007 00
—
FL
01
—
P00065042
MEDICARE RAILROAD
FL
01
—
Y6115
BLUE CROSS & BLUE SHIELD
FL
Enumeration date
08/01/2006
Last updated
04/08/2014
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