Healthcare Provider Details

I. General information

NPI: 1518411388
Provider Name (Legal Business Name): ALICE ALBAUGH HUFFORD PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7927 STATE ROAD 52
HUDSON FL
34667-6783
US

IV. Provider business mailing address

6425 RIVER RD
NEW PORT RICHEY FL
34652-2225
US

V. Phone/Fax

Practice location:
  • Phone: 727-378-8586
  • Fax:
Mailing address:
  • Phone: 727-919-6265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA18771
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: