Provider Demographics
NPI:1730581752
Name:PRADILLA, LAUREN CASEY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:CASEY
Last Name:PRADILLA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:CASEY
Other - Last Name:LOVELADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:17796 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-3923
Mailing Address - Country:US
Mailing Address - Phone:954-438-7800
Mailing Address - Fax:
Practice Address - Street 1:1011 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3249
Practice Address - Country:US
Practice Address - Phone:281-367-1912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT363822251X0800X
TX12658212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic