Provider Demographics
NPI:1124586888
Name:PETERS, ALEXIS (PT, DPT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4909
Mailing Address - Country:US
Mailing Address - Phone:407-691-7687
Mailing Address - Fax:407-691-7697
Practice Address - Street 1:1341 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4909
Practice Address - Country:US
Practice Address - Phone:407-691-7687
Practice Address - Fax:407-691-7697
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT41328225100000X, 2251X0800X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer