Healthcare Provider Details

I. General information

NPI: 1578427969
Provider Name (Legal Business Name): ANASTASIA K KOLIAS SKORDAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20940 UPTOWN AVE APT 332
BOCA RATON FL
33428-6564
US

IV. Provider business mailing address

20940 UPTOWN AVE APT 332
BOCA RATON FL
33428-6564
US

V. Phone/Fax

Practice location:
  • Phone: 224-616-1505
  • Fax:
Mailing address:
  • Phone: 224-616-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: