Provider Demographics
NPI:1548482524
Name:ESTRADA, STEVEN D (PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:ESTRADA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 10TH AVE S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1200
Mailing Address - Country:US
Mailing Address - Phone:205-930-2600
Mailing Address - Fax:205-930-2605
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:SUITE 103
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1200
Practice Address - Country:US
Practice Address - Phone:205-930-2600
Practice Address - Fax:205-930-2605
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-24479OtherBLUE CROSS PROVIDER NUMBE
AL90015Medicare UPIN