Individual
DAVID GANCEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2020 NE 163RD ST STE 207, NORTH MIAMI BEACH, FL 33162-4927
(305) 949-6461
Mailing address
3718 NW 12TH TER, MIAMI, FL 33126-2617
(305) 917-5920
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PTA29228
FL
225200000X
Physical Therapy Assistant
Primary
PTA28227
FL
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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