Healthcare Provider Details

I. General information

NPI: 1821406935
Provider Name (Legal Business Name): BRITTANY AQUART DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 NW 167TH ST
MIAMI GARDENS FL
33056-4406
US

IV. Provider business mailing address

2727 NW 167TH ST
MIAMI GARDENS FL
33056-4406
US

V. Phone/Fax

Practice location:
  • Phone: 305-622-7575
  • Fax: 305-622-9464
Mailing address:
  • Phone: 305-622-7575
  • Fax: 305-622-9464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT 29475
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: