Provider Demographics
NPI:1881062784
Name:KFK PHYSIO, INC.
Entity type:Organization
Organization Name:KFK PHYSIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:F
Authorized Official - Last Name:KRUPA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:570-574-7517
Mailing Address - Street 1:185 SW 7TH ST
Mailing Address - Street 2:UNIT 3304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2990
Mailing Address - Country:US
Mailing Address - Phone:570-574-7517
Mailing Address - Fax:
Practice Address - Street 1:185 SW 7TH ST
Practice Address - Street 2:UNIT 3304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2990
Practice Address - Country:US
Practice Address - Phone:570-574-7517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 29301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty