Active NPI
Alex David Harris II
- Physical Therapy Assistant
- Winter Haven, FL
National Provider Identifier
1538750344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 29957
- Practice address
- 101 Overlook Drive
Winter Haven, FL 33884-3388 - Phone
- (863) 268-2608
- NPI assigned
- Feb 3, 2021
- Last updated
- Feb 3, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 29957 | FL | Primary |
Addresses
Primary practice location
101 Overlook Drive
Winter Haven, FL 33884-3388
Mailing address
2110 Embry Ave
Haines City, FL 33844-9103
Phone (863) 206-0526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29957 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612310400000",
"number": "1538750344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 EMBRY AVE",
"city": "HAINES CITY",
"state": "FL",
"postal_code": "338449103",
"telephone_number": "863-206-0526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 OVERLOOK DRIVE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338843388",
"telephone_number": "863-268-2608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ALEX",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"name_suffix": "II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-03",
"last_updated": "2021-02-03",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "29957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.