=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013324201
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KYMBERLI TERRIEL ABLE-BROWN PT, DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2014
-----------------------------------------------------
Last Update Date | 08/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 920 SABAL BREEZE LN
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-6242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-200-4167
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 920 SABAL BREEZE LN
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-6242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-200-4167
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT31124
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------