Provider Demographics
NPI:1174651145
Name:GARIBAY, ALEJANDRO (PT, ATC)
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:
Last Name:GARIBAY
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9962 COLONIAL WALK S
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6258
Mailing Address - Country:US
Mailing Address - Phone:773-802-6572
Mailing Address - Fax:
Practice Address - Street 1:9962 COLONIAL WALK S
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6258
Practice Address - Country:US
Practice Address - Phone:773-802-6572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist