Individual provider · NPI-1

Kelly Stephanie Andrade, DPT

Physical Therapist · Pembroke Pines, FL

NPI number1215519988
StatusActive
Last updated in NPPESSep 30, 2024

Details

NPI
1215519988
Entity type
Individual (NPI-1)
Name
Kelly Stephanie Andrade
Credential
DPT
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 22, 2021
Certification date
Sep 30, 2024
Last updated
Sep 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical TherapistPT41924FLYes
225100000X Physical TherapistPT032266PA
225100000X Physical Therapist13686MN
225100000X Physical Therapist045887NY

Practice location

17017 Nw 11th St
Pembroke Pines, FL 33028-2101

Phone 954-802-7340

Mailing address

456 W 167th St Apt 6f
New York, NY 10032-4435

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