Provider Demographics
NPI:1619042298
Name:BREDY, YONEL JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:YONEL
Middle Name:
Last Name:BREDY
Suffix:JR
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 1:10590 INDEPENDENCE POINTE PKWY
Mailing Address - Street 2:STE 201
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4176
Mailing Address - Country:US
Mailing Address - Phone:786-269-8070
Mailing Address - Fax:
Practice Address - Street 1:10590 INDEPENDENCE POINTE PKWY
Practice Address - Street 2:STE 201
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4176
Practice Address - Country:US
Practice Address - Phone:786-269-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20059225100000X
FLPT212172251H1200X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1619042298Medicaid
FL016964700Medicaid
FLIN970AMedicare UPIN
FLU8857YMedicare UPIN