Provider Demographics
NPI:1023352572
Name:PAULA, DAVID ANTHONY (PT, DPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANTHONY
Last Name:PAULA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 NW 107TH AVE
Mailing Address - Street 2:SUITE # 107
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4327
Mailing Address - Country:US
Mailing Address - Phone:786-452-0774
Mailing Address - Fax:786-452-0764
Practice Address - Street 1:3655 NW 107TH AVE
Practice Address - Street 2:SUITE # 107
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4327
Practice Address - Country:US
Practice Address - Phone:786-452-0774
Practice Address - Fax:786-452-0764
Is Sole Proprietor?:No
Enumeration Date:2012-11-23
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist