Provider Demographics
NPI:1447795174
Name:NAJ, KAYLEE (PTA)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:NAJ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12146 CUDDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5534
Mailing Address - Country:US
Mailing Address - Phone:954-478-3104
Mailing Address - Fax:
Practice Address - Street 1:12146 CUDDINGTON CT
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-5534
Practice Address - Country:US
Practice Address - Phone:954-478-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26846225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant