Provider Demographics
NPI:1508513086
Name:KWIATKOWSKI, ALEXIA KYLE (PT, DPT, CLT)
Entity Type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:KYLE
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:DR
Other - First Name:ALEXIA
Other - Middle Name:KYLE
Other - Last Name:KWIATKOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:1830 N UNIVERSITY DR # 269
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4114
Mailing Address - Country:US
Mailing Address - Phone:305-306-4110
Mailing Address - Fax:
Practice Address - Street 1:1830 N UNIVERSITY DR # 269
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4114
Practice Address - Country:US
Practice Address - Phone:305-306-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist