Provider Demographics
NPI:1750395547
Name:AFANADOR, ESTELA (PT)
Entity type:Individual
Prefix:
First Name:ESTELA
Middle Name:
Last Name:AFANADOR
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 1:3800 HILLCREST DR
Mailing Address - Street 2:305
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7976
Mailing Address - Country:US
Mailing Address - Phone:954-322-0818
Mailing Address - Fax:
Practice Address - Street 1:3800 HILLCREST DR
Practice Address - Street 2:305
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-7976
Practice Address - Country:US
Practice Address - Phone:954-322-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAD009ZMedicare PIN