Healthcare Provider Details

I. General information

NPI: 1912825423
Provider Name (Legal Business Name): NEIL DAWSON KUBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3876 HIGHWAY 90
PACE FL
32571-1014
US

IV. Provider business mailing address

2123 COPLEY DR
PENSACOLA FL
32503-3448
US

V. Phone/Fax

Practice location:
  • Phone: 448-227-7071
  • Fax:
Mailing address:
  • Phone: 448-227-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: