Doctor Name: | RANDALL KIDD |
NPI Number: | 1861826802 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PT28454 |
Business Practice Address: | 9929 Pines Blvd Pembroke Pines, FL - 330246175 |
Business Phone Number: | 9544378099 |
Business Fax Number: | |
Mailing Address: | 9410 Tangerine Pl, 406 DAVIE |
State: | FL |
Postal Code: | 333244471 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/27/2013 |
NPI Last Update Date: | 08/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT28454 |
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 |