Provider Demographics
NPI:1184404022
Name:SANCHEZ KADERKULOW, JULIO CESAR (PT)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:SANCHEZ KADERKULOW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 WASHINGTON ST APT 114
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7675
Mailing Address - Country:US
Mailing Address - Phone:754-779-9821
Mailing Address - Fax:
Practice Address - Street 1:8612 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3719
Practice Address - Country:US
Practice Address - Phone:954-252-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist