Provider Demographics
NPI:1114167871
Name:PENAFLORIDA, ALEXIS PASTERA (PT)
Entity Type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:PASTERA
Last Name:PENAFLORIDA
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Gender:M
Credentials:PT
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Mailing Address - Street 1:PO BOX #4447
Mailing Address - Street 2:DOWNTOWN SPINE SPORTS & ORTHOPEDIC REHABILITATION PC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004
Mailing Address - Country:US
Mailing Address - Phone:212-422-1111
Mailing Address - Fax:212-867-2255
Practice Address - Street 1:55 BROAD STREET
Practice Address - Street 2:SUITE #15F DOWNTOWN SPINE SPORTS & ORTHOPEDIC REHABILI
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004
Practice Address - Country:US
Practice Address - Phone:212-422-1111
Practice Address - Fax:212-867-2255
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-12-08
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Provider Licenses
StateLicense IDTaxonomies
NY023679208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist