Provider Demographics
NPI:1609224435
Name:MARTINEZ, ALEC JOHN (DPT)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:JOHN
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 MOHAWK RD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34715-7433
Mailing Address - Country:US
Mailing Address - Phone:352-732-8868
Mailing Address - Fax:
Practice Address - Street 1:236 MOHAWK RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715-7433
Practice Address - Country:US
Practice Address - Phone:352-732-8868
Practice Address - Fax:352-404-6909
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31464225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist