Healthcare Provider Details

I. General information

NPI: 1912795626
Provider Name (Legal Business Name): TAYLOR ALEXANDRA RAYMOND DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 SAXON BLVD STE 301
DELTONA FL
32725-5836
US

IV. Provider business mailing address

100 E 2ND AVE STE 210
ROME GA
30161-1718
US

V. Phone/Fax

Practice location:
  • Phone: 386-851-0901
  • Fax: 386-851-2426
Mailing address:
  • Phone: 386-851-0901
  • Fax: 386-851-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT43229
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: