Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bouakham Chanthavongnasaeng

Individual provider Physical Therapy Assistant · NPI 1346829751

Bouakham Chanthavongnasaeng is a Physical Therapy Assistant in Deerfield Beach, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

401 E Sample Rd
Deerfield Beach, FL 33064-4441
Phone: (954) 941-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA25966 (FL)
Physical Therapy Assistant Taxonomy 225200000X

Record details

NPI number1346829751
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 4, 2021
Last updated in NPPESApril 4, 2021
Certification dateApril 4, 2021

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