Provider Demographics
NPI:1003101361
Name:BOWER, KATHLEEN M (PT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:BOWER
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 1:1500 MONZA AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3087
Mailing Address - Country:US
Mailing Address - Phone:305-740-6001
Mailing Address - Fax:
Practice Address - Street 1:1500 MONZA AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3087
Practice Address - Country:US
Practice Address - Phone:305-740-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 26449225100000X
CA300947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist