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General NPI Number Information
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NPI Number | 1558967646
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Entity Type | Individual
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Provider Name | ALEXANDER IAN MACAISA OT
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Gender | Male
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Dates
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Enumeration Date | 12/05/2020
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 9711 W OAKLAND PARK BLVD
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City | SUNRISE
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State | FL
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Zip | 33351-7013
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Country | US
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Telephone | 954-572-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 409 PALM CIR E
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1194
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Country | US
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Telephone | 786-546-9605
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT21347
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License Number State | FL
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