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General NPI Number Information
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NPI Number | 1902359359
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Entity Type | Individual
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Provider Name | ALEXANDER WANN DPT
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Gender | Male
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 5717 DEREK AVE
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City | SARASOTA
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State | FL
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Zip | 34233-2413
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Country | US
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Telephone | 941-735-1225
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Fax | 941-218-5627
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | BIRMINGHAM
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-8923
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Fax | 423-954-7399
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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 | 05012661A
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License Number State | IN
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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 | 1281099
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT33282
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License Number State | FL
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