Healthcare Provider Details

I. General information

NPI: 1831533702
Provider Name (Legal Business Name): KENDALL PHYSICAL THERAPY & HAND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13500 SW 88TH ST SUITE 185
MIAMI FL
33186-1515
US

IV. Provider business mailing address

13500 SW 88TH ST SUITE 185
MIAMI FL
33186-1515
US

V. Phone/Fax

Practice location:
  • Phone: 305-408-7353
  • Fax: 305-408-7355
Mailing address:
  • Phone: 305-408-7353
  • Fax: 305-408-7355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberHCC3012
License Number StateFL

VIII. Authorized Official

Name: CHRISTA PAULINE BAGGOTT
Title or Position: MGR
Credential: OT CHT
Phone: 305-969-0830