Healthcare Provider Details

I. General information

NPI: 1689546145
Provider Name (Legal Business Name): ALEJANDRA SOFIA DE LOS RIOS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 NW 14TH AVE
MIAMI FL
33125-1616
US

IV. Provider business mailing address

193 SW 96TH TER
PLANTATION FL
33324-2363
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-1080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number27315
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: