Provider Demographics
NPI:1265865604
Name:ALEXANDER SPINE AND PHYSICAL MEDICINE PA
Entity Type:Organization
Organization Name:ALEXANDER SPINE AND PHYSICAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-397-3000
Mailing Address - Street 1:10720 PARK BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-5461
Mailing Address - Country:US
Mailing Address - Phone:727-397-3000
Mailing Address - Fax:727-397-3004
Practice Address - Street 1:10720 PARK BLVD STE A
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-5461
Practice Address - Country:US
Practice Address - Phone:727-397-3000
Practice Address - Fax:727-397-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7623111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty