Healthcare Provider Details

I. General information

NPI: 1053227231
Provider Name (Legal Business Name): KAYLA MARIE BOOROS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 FRANKLIN AVE STE 405
BERLIN MD
21811-1263
US

IV. Provider business mailing address

314 FRANKLIN AVE STE 405
BERLIN MD
21811-1263
US

V. Phone/Fax

Practice location:
  • Phone: 410-641-2900
  • Fax: 410-641-2900
Mailing address:
  • Phone: 410-641-2900
  • Fax: 410-641-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: