Provider Demographics
NPI:1750452850
Name:PRADO, ADRIANA (PT)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:PRADO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 PEREGRINE WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2369
Mailing Address - Country:US
Mailing Address - Phone:305-300-5526
Mailing Address - Fax:
Practice Address - Street 1:2237 N COMMERCE PKWY STE 2
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3250
Practice Address - Country:US
Practice Address - Phone:954-888-6650
Practice Address - Fax:954-888-6645
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17924225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6780AMedicare ID - Type Unspecified
FLBS765Medicare UPIN