Provider Demographics
NPI:1861369142
Name:DUGGAN, ALEXANDRA JOAN
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JOAN
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:DUGGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:950 PENINSULA CORPORATE CIR STE 3004
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1387
Mailing Address - Country:US
Mailing Address - Phone:561-501-1983
Mailing Address - Fax:561-270-6965
Practice Address - Street 1:18312 102ND WAY S
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-1663
Practice Address - Country:US
Practice Address - Phone:561-985-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist