Individual
KEVEN BRYAN FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
13717 SW 152ND ST, MIAMI, FL 33177-1106
(305) 252-1400
Mailing address
8800 NW 108TH LN, HIALEAH, FL 33018-4525
(305) 205-0668
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26995
FL
Other
Enumeration date
02/26/2017
Last updated
02/26/2017
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