Provider Demographics
NPI:1043272461
Name:MONDUORI, ALYSHA NICOLE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ALYSHA
Middle Name:NICOLE
Last Name:MONDUORI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 WATERFORD CIR E
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-7211
Mailing Address - Country:US
Mailing Address - Phone:352-870-5400
Mailing Address - Fax:
Practice Address - Street 1:3890 TAMPA RD STE 303
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3677
Practice Address - Country:US
Practice Address - Phone:727-787-5577
Practice Address - Fax:727-781-7757
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 21631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherMEDICARE