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NPI Code Detail

MEDICARE: ALEXUS TENNANT DPT

MEDICARE: ALEXUS TENNANT DPT
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
1225100000XPhysical TherapistPT40344FL

General Provider Information

NPI Number : 1497437891
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXUS TENNANT DPT
Provider Business Mailing Address
First Line : 4137 SW 66TH WAY
Second Line :
City : DAVIE
State : FL
Zip : 33314-3345
Country : US
Telephone Number : 309-798-8317
Fax Number :
Provider Business Practice Location Address
First Line : 805 SE 3RD AVE STE 2
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33316-1193
Country : US
Telephone Number : 954-256-9052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2023
Last Update Date : 08/04/2023

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Directions to “ ALEXUS TENNANT DPT” Practice Location

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