Provider Demographics
NPI:1336917541
Name:HARDIN, DARRELL II (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:
Last Name:HARDIN
Suffix:II
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 1:1300 NE MIAMI GARDENS DR APT 216E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4730
Mailing Address - Country:US
Mailing Address - Phone:615-337-9632
Mailing Address - Fax:
Practice Address - Street 1:777 SE 20TH ST STE 200
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-3589
Practice Address - Country:US
Practice Address - Phone:954-302-7717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL41013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist