Healthcare Provider Details

I. General information

NPI: 1558111468
Provider Name (Legal Business Name): RACHEL BUBBEL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 03/25/2024
Certification Date: 03/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10124 NW 27TH AVE
MIAMI FL
33147-1759
US

IV. Provider business mailing address

10124 NW 27TH AVE
MIAMI FL
33147-1759
US

V. Phone/Fax

Practice location:
  • Phone: 305-390-4252
  • Fax: 305-390-4255
Mailing address:
  • Phone: 305-390-4252
  • Fax: 305-390-4255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT35297
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: