Provider Demographics
NPI:1801183389
Name:DEMERS, ALEXANDRA S (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:S
Last Name:DEMERS
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 1:1290 PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4950
Mailing Address - Country:US
Mailing Address - Phone:407-801-2928
Mailing Address - Fax:
Practice Address - Street 1:1290 PALMETTO AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4950
Practice Address - Country:US
Practice Address - Phone:407-801-2928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13617225100000X
MD23707225100000X
FLPT35155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q41708AMedicare UPIN