Provider Demographics
NPI:1336273051
Name:KINFU, DESHY (PT)
Entity type:Individual
Prefix:
First Name:DESHY
Middle Name:
Last Name:KINFU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2309
Mailing Address - Country:US
Mailing Address - Phone:571-213-3257
Mailing Address - Fax:
Practice Address - Street 1:6900 DANIELS PKWY STE 36
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1587
Practice Address - Country:US
Practice Address - Phone:239-936-4404
Practice Address - Fax:239-936-5156
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20193225100000X
FLPT43204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist