Provider Demographics
NPI:1265038608
Name:PICADO, FELIPE A (PT)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:A
Last Name:PICADO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9334 E SWEETWATER DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-7378
Mailing Address - Country:US
Mailing Address - Phone:352-476-2738
Mailing Address - Fax:
Practice Address - Street 1:6971 N FEDERAL HWY STE 305
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1617
Practice Address - Country:US
Practice Address - Phone:561-241-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist