Provider Demographics
NPI:1114519121
Name:CSADY, AUSTIN TAYLOR (PTA)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:TAYLOR
Last Name:CSADY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 MONTEREY DR NE APT 102
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-7584
Mailing Address - Country:US
Mailing Address - Phone:321-626-7865
Mailing Address - Fax:
Practice Address - Street 1:1310 37TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4860
Practice Address - Country:US
Practice Address - Phone:772-569-5107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30794225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant