Individual
ALAN ATOGAMIS DE SOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
500 N SEMORAN BLVD STE 101, ORLANDO, FL 32807-3381
(407) 815-6555
Mailing address
1656 WILKINSON WAY SE, SMYRNA, GA 30080-1604
(206) 566-1078
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT39673
FL
225700000X
Massage Therapist
MT012759
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA99739
MEDICAL LICENSE
FL
01
—
PT39673
MEDICAL LICENSE
FL
Enumeration date
09/09/2020
Last updated
12/22/2022
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