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General NPI Number Information
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NPI Number | 1710853965
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Entity Type | Individual
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Provider Name | SEBASTIAN ALEXANDER TEIXEIRA
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Gender | Male
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 13101 S DIXIE HWY STE 330
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City | PINECREST
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State | FL
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Zip | 33156-6530
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Country | US
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Telephone | 786-732-7438
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Fax |
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Provider Business Mailing Address
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Address Line | 3035 SE 4TH PL
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City | HOMESTEAD
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State | FL
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Zip | 33033-5769
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT43766
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License Number State | FL
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