Provider Demographics
NPI:1205116597
Name:TERPOS, ALEXANDRA (DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:TERPOS
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 1:1050 BRICKELL AVE
Mailing Address - Street 2:806
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3945
Mailing Address - Country:US
Mailing Address - Phone:908-872-5940
Mailing Address - Fax:908-872-5940
Practice Address - Street 1:1050 BRICKELL AVE
Practice Address - Street 2:806
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3945
Practice Address - Country:US
Practice Address - Phone:908-872-5940
Practice Address - Fax:908-872-5940
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24613174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3399AMedicare UPIN