| Doctor Name: | SUBIN JOSE PUTHENKANDAM |
| NPI Number: | 1205171881 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT27872 |
| Business Practice Address: | 5745 S University Dr Davie, FL - 333286114 |
| Business Phone Number: | 9542529619 |
| Business Fax Number: | |
| Mailing Address: | 321 E Sheridan St, Apt 307 DANIA BEACH |
| State: | FL |
| Postal Code: | 330045571 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2012 |
| NPI Last Update Date: | 12/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT27872 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |