Provider Demographics
NPI:1841585767
Name:ALLEN, ALISSA ORFELY (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:ORFELY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 S STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4055
Mailing Address - Country:US
Mailing Address - Phone:954-316-1131
Mailing Address - Fax:
Practice Address - Street 1:747 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4055
Practice Address - Country:US
Practice Address - Phone:954-316-1131
Practice Address - Fax:954-316-1141
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist