Provider Demographics
NPI:1659321008
Name:FINSTAD, ALIYAH (PTA, CLT)
Entity Type:Individual
Prefix:
First Name:ALIYAH
Middle Name:
Last Name:FINSTAD
Suffix:
Gender:F
Credentials:PTA, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30201 SW 172ND AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4820
Mailing Address - Country:US
Mailing Address - Phone:305-878-2158
Mailing Address - Fax:305-248-9778
Practice Address - Street 1:30201 SW 172ND AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4820
Practice Address - Country:US
Practice Address - Phone:305-878-2158
Practice Address - Fax:305-248-9778
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20194225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant