Provider Demographics
NPI:1407932866
Name:RADE, EMILY ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:RADE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 SOUTH HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317
Mailing Address - Country:US
Mailing Address - Phone:954-533-7401
Mailing Address - Fax:954-990-4720
Practice Address - Street 1:4101 SOUTH HOSPITAL DRIVE
Practice Address - Street 2:SUITE 16
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:954-533-7401
Practice Address - Fax:954-990-4720
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
023426-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1779725OtherUNITED HEALTHCARE