Provider Demographics
NPI:1942753397
Name:COLAS, STEPHANIE (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:COLAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:COLAS-SALGADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:2234 NE 3RD CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-6054
Mailing Address - Country:US
Mailing Address - Phone:786-486-0543
Mailing Address - Fax:
Practice Address - Street 1:2234 NE 3RD CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-6054
Practice Address - Country:US
Practice Address - Phone:786-486-0543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist