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Individual
SHRUTI ANVAY PRADHAN
Active
Individual
SHRUTI ANVAY PRADHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, MS
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
PT 30996
FL
225100000X
Physical Therapist
Primary
PT 30996
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016465400
—
FL
Enumeration date
01/05/2016
Last updated
08/01/2019
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