Provider Demographics
NPI:1467881482
Name:GRIFFITH, ANDREW D (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 MALABAR RD SE UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3124
Mailing Address - Country:US
Mailing Address - Phone:321-757-5515
Mailing Address - Fax:321-757-5514
Practice Address - Street 1:709 S HARBOR CITY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1936
Practice Address - Country:US
Practice Address - Phone:321-802-5814
Practice Address - Fax:321-802-5811
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13057225100000X
FLPT34581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist