MEDICARE: MS. ALEXANDRA V VILLEGAS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT16605	FL

General Provider Information

NPI Number	:	1043327299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALEXANDRA V VILLEGAS PT

Provider Business Mailing Address
First Line	:	1052 JEFFERSON AVE
Second Line	:	APT. #5
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4842
Country	:	US
Telephone Number	:	305-527-2672
Fax Number	:

Provider Business Practice Location Address
First Line	:	1052 JEFFERSON AVE APT 5
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4842
Country	:	US
Telephone Number	:	305-527-2672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	04/30/2009

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