Provider Demographics
NPI:1568932663
Name:DOLGOFF, ALEXIS (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DOLGOFF
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7764 NW 70TH WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3954
Mailing Address - Country:US
Mailing Address - Phone:954-684-6293
Mailing Address - Fax:954-346-4008
Practice Address - Street 1:12040 S JOG RD STE 8
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-4164
Practice Address - Country:US
Practice Address - Phone:561-733-5083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist