1215228069 NPI number — ALEXANDRA GIANNINI MS, ATC, LAT, CSCS

Table of content: ALEXANDRA GIANNINI MS, ATC, LAT, CSCS (NPI 1215228069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215228069 NPI number — ALEXANDRA GIANNINI MS, ATC, LAT, CSCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIANNINI
Provider First Name:
ALEXANDRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC, LAT, CSCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUNLEY
Provider Other First Name:
ALEXANDRA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, ATC, LAT, CSCS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215228069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
231 BOBWHITE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROYAL PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33411-1718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-784-5904
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2240 PALM BEACH LAKES BLVD
Provider Second Line Business Practice Location Address:
STE. 225
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33409-3410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-684-8774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  AL2663 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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