Provider Demographics
NPI:1871677831
Name:MCAVOY, ALISON (PT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:MCAVOY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:14194 EQUESTRIAN WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-7625
Mailing Address - Country:US
Mailing Address - Phone:561-795-7765
Mailing Address - Fax:
Practice Address - Street 1:13873 WELLINGTON TRCE
Practice Address - Street 2:SUITE B-12
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-2118
Practice Address - Country:US
Practice Address - Phone:561-790-7886
Practice Address - Fax:561-790-4427
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2764ZMedicare ID - Type Unspecified
FLQ18595Medicare UPIN