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General NPI Number Information
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NPI Number | 1588843189
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Entity Type | Individual
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Provider Name | ALEXANDER CAGUIOA GARDUQUE RPT
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Gender | Male
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 2041 W STATE ROAD 426
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City | OVIEDO
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State | FL
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Zip | 32765-8548
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Country | US
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Telephone | 407-365-5676
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Fax |
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Provider Business Mailing Address
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Address Line | 437 LAGOON DR
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City | OVIEDO
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State | FL
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Zip | 32765-6218
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Country | US
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Telephone | 201-315-9830
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT40QA00804200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 35118
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License Number State | FL
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