Healthcare Provider Details

I. General information

NPI: 1215843131
Provider Name (Legal Business Name): ALEXANDER HERNANDEZ ESCAMILLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 PAVILION WAY
SOUTHERN PINES NC
28387-4563
US

IV. Provider business mailing address

5032 NC 705 HWY
ROBBINS NC
27325-8265
US

V. Phone/Fax

Practice location:
  • Phone: 910-235-2713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25239
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: