Provider Demographics
NPI:1851510218
Name:LAYNE, HOWARD (DPT)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:LAYNE
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 1:5200 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5316
Mailing Address - Country:US
Mailing Address - Phone:954-382-4343
Mailing Address - Fax:954-382-4342
Practice Address - Street 1:5200 S UNIVERSITY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5316
Practice Address - Country:US
Practice Address - Phone:954-382-4343
Practice Address - Fax:954-382-4342
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT179302251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY80170ZMedicare ID - Type Unspecified