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General NPI Number Information
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NPI Number | 1477950152
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Entity Type | Individual
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Provider Name | ALEXANDER RAUL PORRAS PTA
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Gender | Male
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 8303 S DIXIE HWY STE 308
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City | MIAMI
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State | FL
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Zip | 33143-7713
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Country | US
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Telephone | 305-661-1441
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 SW 127TH WAY
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City | MIAMI
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State | FL
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Zip | 33175-6256
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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 | PTA 23782
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License Number State | FL
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