Healthcare Provider Details

I. General information

NPI: 1174278923
Provider Name (Legal Business Name): ALYSE HAUSMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2022
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-4312
US

IV. Provider business mailing address

5233 HEATHWOOD GABLE TER
JACKSONVILLE FL
32257-3779
US

V. Phone/Fax

Practice location:
  • Phone: 904-345-7251
  • Fax:
Mailing address:
  • Phone: 561-847-5740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2025-0022
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT-2025-0022
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT37330
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: