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General NPI Number Information
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NPI Number | 1225836364
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Entity Type | Individual
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Provider Name | ANDREW SEBASTIAN CAICEDO PTA
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Gender | Male
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 897 N HOMESTEAD BLVD BLDG SUITE101
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City | HOMESTEAD
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State | FL
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Zip | 33030-5024
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Country | US
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Telephone | 786-217-0014
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Fax |
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Provider Business Mailing Address
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Address Line | 15061 SW 42ND TER
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City | MIAMI
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State | FL
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Zip | 33185-4351
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA33831
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License Number State | FL
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