Healthcare Provider Details

I. General information

NPI: 1487962999
Provider Name (Legal Business Name): CORY ABBATE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 NE 145TH ST
NORTH MIAMI FL
33181-3601
US

IV. Provider business mailing address

12970 NW 6 TERRACE
MIAMI FL
33182-3007
US

V. Phone/Fax

Practice location:
  • Phone: 305-335-3978
  • Fax: 833-441-1807
Mailing address:
  • Phone: 305-335-3978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT 25889
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: