Provider Demographics
NPI:1770281065
Name:CESPEDES, ALEXANDER (PTA)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:CESPEDES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 NW 4TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32603-1686
Mailing Address - Country:US
Mailing Address - Phone:863-444-0644
Mailing Address - Fax:
Practice Address - Street 1:4820 NEWBERRY RD # 2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2249
Practice Address - Country:US
Practice Address - Phone:352-758-5495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA32558225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant