Provider Demographics
NPI:1215816780
Name:AMIRIZADEH, KAYVON (DPT)
Entity type:Individual
Prefix:
First Name:KAYVON
Middle Name:
Last Name:AMIRIZADEH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6523 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4943
Mailing Address - Country:US
Mailing Address - Phone:786-808-9690
Mailing Address - Fax:
Practice Address - Street 1:2243 N MIAMI AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-5823
Practice Address - Country:US
Practice Address - Phone:786-684-8796
Practice Address - Fax:954-281-9019
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT43104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist