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NPI Code Detail

MEDICARE: MISS ALYSA CANTAVE PTA

MEDICARE:  MISS ALYSA  CANTAVE  PTA
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
1225200000XPhysical Therapy AssistantPTA26479FL

General Provider Information

NPI Number : 1609234616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALYSA CANTAVE PTA
Provider Business Mailing Address
First Line : 8993 OKEECHOBEE BLVD
Second Line : 100
City : WEST PALM BEACH
State : FL
Zip : 33411-5144
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8993 OKEECHOBEE BLVD
Second Line : 100
City : WEST PALM BEACH
State : FL
Zip : 33411-5144
Country : US
Telephone Number : 561-478-3702
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2016
Last Update Date : 06/28/2016

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Directions to “ MISS ALYSA CANTAVE PTA” Practice Location

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