Provider Demographics
NPI:1740054089
Name:RAMIREZ, ALEXANDER S (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:S
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5552 W SHANGRI LA RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-3848
Mailing Address - Country:US
Mailing Address - Phone:623-329-4403
Mailing Address - Fax:
Practice Address - Street 1:17300 N PERIMETER DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6597
Practice Address - Country:US
Practice Address - Phone:602-483-1710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-33164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist