Provider Demographics
NPI:1720178767
Name:KAPADIA, MONA PATEL (DPT, MSPT)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:PATEL
Last Name:KAPADIA
Suffix:
Gender:F
Credentials:DPT, MSPT
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:RAJANIKANT
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, MSPT
Mailing Address - Street 1:13020 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0925
Mailing Address - Country:US
Mailing Address - Phone:813-978-9700
Mailing Address - Fax:813-588-6186
Practice Address - Street 1:13020 N TELECOM PKWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-0925
Practice Address - Country:US
Practice Address - Phone:813-978-9700
Practice Address - Fax:813-558-6186
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007928225100000X
MD24939225100000X
FLPT305122251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT15302OtherORTHO NET
CT080007928CT01OtherBLUE CARE FAMIL PLAN
CT080007928CT01OtherBCBS ID
CT004264660OtherGHMC GROUP MEDICAID PROVI
CT370458OtherWELLCARE MEDICARE ONLY
CT1470171OtherAETNA
CT004264678Medicaid
CT1255448155OtherGHMC GROUP NPI ID
CT2V9101OtherHEALTH NET
CT1470171OtherAETNA
CT1255448155OtherGHMC GROUP NPI ID
CT004264678Medicaid