MEDICARE: ALEXANDER DIANDRE' IRBY

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

General Provider Information

NPI Number	:	1578412219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER DIANDRE' IRBY

Provider Business Mailing Address
First Line	:	2428B WATSON ST
Second Line	:
City	:	ELGIN
State	:	SC
Zip	:	29045-8815
Country	:	US
Telephone Number	:	803-347-3334
Fax Number	:

Provider Business Practice Location Address
First Line	:	8612 GRIFFIN RD
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-3719
Country	:	US
Telephone Number	:	954-252-8900
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ ALEXANDER DIANDRE' IRBY ” Practice Location

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