Provider Demographics
NPI:1700472735
Name:APONTE, ALEX RUBY JR (PTA)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:RUBY
Last Name:APONTE
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:710 JENNYMAC DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-6042
Mailing Address - Country:US
Mailing Address - Phone:502-269-6623
Mailing Address - Fax:
Practice Address - Street 1:7402 STEEPLECREST CIR APT 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-9141
Practice Address - Country:US
Practice Address - Phone:502-650-0977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA04072225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant