Provider Demographics
NPI:1518277243
Name:ANDRADE, OSVALDO P (RPT)
Entity Type:Individual
Prefix:
First Name:OSVALDO
Middle Name:P
Last Name:ANDRADE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1393 SW 1ST ST
Mailing Address - Street 2:415
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2321
Mailing Address - Country:US
Mailing Address - Phone:786-953-6735
Mailing Address - Fax:786-953-6943
Practice Address - Street 1:1393 SW 1ST ST
Practice Address - Street 2:415
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2321
Practice Address - Country:US
Practice Address - Phone:786-953-6735
Practice Address - Fax:786-953-6943
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT3221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist