Provider Demographics
NPI:1376811455
Name:SARMIENTO, ALEKSANDRA ANNA (PTA)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:ANNA
Last Name:SARMIENTO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8746 SW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-4320
Mailing Address - Country:US
Mailing Address - Phone:954-689-4465
Mailing Address - Fax:
Practice Address - Street 1:8746 SW 53RD ST
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-4320
Practice Address - Country:US
Practice Address - Phone:954-689-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 19192225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant