Provider Demographics
NPI:1265293328
Name:ANDAYA, CHRISTIAN TANDOC (BSPT)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:TANDOC
Last Name:ANDAYA
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 FAIRFAX DR
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-3510
Mailing Address - Country:US
Mailing Address - Phone:954-243-8325
Mailing Address - Fax:
Practice Address - Street 1:1650 FAIRFAX DR
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-3510
Practice Address - Country:US
Practice Address - Phone:954-243-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT92752251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics