Provider Demographics
NPI:1942358155
Name:VILLARANTE, ALVIN ANGELO JUSTINIANI (PT)
Entity Type:Individual
Prefix:MR
First Name:ALVIN ANGELO
Middle Name:JUSTINIANI
Last Name:VILLARANTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:ALVIN ANGELO
Other - Middle Name:
Other - Last Name:VILLARANTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:6305 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2604
Mailing Address - Country:US
Mailing Address - Phone:941-761-3499
Mailing Address - Fax:941-567-1812
Practice Address - Street 1:6305 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2604
Practice Address - Country:US
Practice Address - Phone:941-761-3499
Practice Address - Fax:941-567-1812
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT 11325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT 11325OtherPT