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General NPI Number Information
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NPI Number | 1114640299
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Entity Type | Individual
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Provider Name | ALVIS TRAN PTA
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Gender | Male
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 5461 JOHNSON RD
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3610
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Country | US
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Telephone | 954-246-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 2672 NW 64TH TER
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City | MARGATE
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State | FL
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Zip | 33063-1733
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 32251
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License Number State | FL
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