Provider Demographics
NPI:1235606872
Name:KEREKES, ALEXANDER (PTA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:KEREKES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 DRUID RD E
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4210
Mailing Address - Country:US
Mailing Address - Phone:727-442-2236
Mailing Address - Fax:727-442-2646
Practice Address - Street 1:1236 DRUID RD E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4210
Practice Address - Country:US
Practice Address - Phone:727-442-2236
Practice Address - Fax:727-442-2646
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA26888208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation