Carmen Rosa Kennedy, PTA

Individual provider Active NPI Physical Therapy Assistant · Surfside, FL

NPI 1992221733 · NPPES record last updated Aug 14, 2017

Key facts

NPI
1992221733
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
9747 (FL)
Practice address
9057 Garland Ave
Surfside, FL 33154-3217
Phone
(786) 316-8826
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9747FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
225200000X 9747 FL Yes

Addresses

Primary practice location

9057 Garland Ave
Surfside, FL 33154-3217

Mailing address

9057 Garland Ave
Surfside, FL 33154-3217

Other names

  • C Rosa Kennedy Professional name

Other providers in Surfside, FL

All providers in Surfside, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.