Provider Demographics
NPI:1740701085
Name:CONDIS, ALEJANDRO (PT)
Entity type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:
Last Name:CONDIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9370 SW 72ND ST STE A150
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5461
Mailing Address - Country:US
Mailing Address - Phone:786-332-2672
Mailing Address - Fax:
Practice Address - Street 1:9370 SW 72ND ST STE A150
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5461
Practice Address - Country:US
Practice Address - Phone:786-332-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18122208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT18122OtherPHYSICAL THERAPIST LICENSE