Provider Demographics
NPI:1598176786
Name:PROPHETE, KEHATILDE
Entity Type:Individual
Prefix:
First Name:KEHATILDE
Middle Name:
Last Name:PROPHETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6848 2ND ST
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3887
Mailing Address - Country:US
Mailing Address - Phone:561-839-0707
Mailing Address - Fax:360-530-6343
Practice Address - Street 1:6848 2ND ST
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3887
Practice Address - Country:US
Practice Address - Phone:561-839-0707
Practice Address - Fax:360-530-6343
Is Sole Proprietor?:No
Enumeration Date:2014-05-11
Last Update Date:2014-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12963227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered