MEDICARE: JAVIER ALEXANDER CARLIN 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

General Provider Information

NPI Number	:	1689180432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVIER ALEXANDER CARLIN PT

Provider Business Mailing Address
First Line	:	10425 SW 112TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-8271
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6810 SW 81ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7708
Country	:	US
Telephone Number	:	305-905-4188
Fax Number	:

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

Provider Enumeration Date	:	12/15/2017
Last Update Date	:	12/15/2017

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Directions to “ JAVIER ALEXANDER CARLIN PT” Practice Location

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