Provider Demographics
NPI:1245520402
Name:KALBFLEISCH, ISMAEL (PTA)
Entity type:Individual
Prefix:
First Name:ISMAEL
Middle Name:
Last Name:KALBFLEISCH
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 N KENDALL DR STE 507
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7566
Mailing Address - Country:US
Mailing Address - Phone:786-517-7998
Mailing Address - Fax:
Practice Address - Street 1:7700 N KENDALL DR STE 507
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7566
Practice Address - Country:US
Practice Address - Phone:786-517-7998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22541225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant