Provider Demographics
NPI:1902908890
Name:ALEXIADIS, ALKIS ROBERT (PT)
Entity Type:Individual
Prefix:MR
First Name:ALKIS
Middle Name:ROBERT
Last Name:ALEXIADIS
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 1:2240 SLOANE PL
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6464
Mailing Address - Country:US
Mailing Address - Phone:561-422-7102
Mailing Address - Fax:561-204-5928
Practice Address - Street 1:2240 SLOANE PL
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6464
Practice Address - Country:US
Practice Address - Phone:561-422-7102
Practice Address - Fax:561-204-5928
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21232225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist