Individual
ALEX A ALTAMIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
13330 USF LAUREL DR, MDC 62, TAMPA, FL 33612-6601
(813) 974-8613
(813) 974-8614
Mailing address
PO BOX 91770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5776
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001588000
—
FL
01
—
5776
LICENSE
SC
01
—
Y01W2
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/13/2008
Last updated
01/29/2010
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