Provider Demographics
NPI:1023232279
Name:AIRD, KAI N (PT)
Entity type:Individual
Prefix:MS
First Name:KAI
Middle Name:N
Last Name:AIRD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KISHNA
Other - Middle Name:N
Other - Last Name:SISCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:18313 JUPITER LANDINGS DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3359
Mailing Address - Country:US
Mailing Address - Phone:561-704-7224
Mailing Address - Fax:561-972-4446
Practice Address - Street 1:18313 JUPITER LANDINGS DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3359
Practice Address - Country:US
Practice Address - Phone:561-704-7224
Practice Address - Fax:561-972-4446
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL180592251G0304X, 2251X0800X
FLPT18059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2V3BOtherBCBS