Provider Demographics
NPI:1003611021
Name:ARNOLD, ALEXANDRA (PT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ARNOLD
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 1:4230 PABLO PROFESSIONAL CT STE 155
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-3223
Mailing Address - Country:US
Mailing Address - Phone:904-996-6922
Mailing Address - Fax:904-996-6923
Practice Address - Street 1:6 FAIRFIELD BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-4628
Practice Address - Country:US
Practice Address - Phone:904-996-6922
Practice Address - Fax:904-996-6923
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist