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General NPI Number Information
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NPI Number | 1205175460
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Entity Type | Organization
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Legal Business Name | BUILDABILITIES LLC
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Dates
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Enumeration Date | 02/07/2013
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 11 CONLEY CT
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City | PALM COAST
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State | FL
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Zip | 32137-9024
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Country | US
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Telephone | 386-585-2951
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CONLEY CT
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City | PALM COAST
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State | FL
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Zip | 32137-9024
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Country | US
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Telephone | 386-585-2951
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. SOCRATES DUARTE NAVOTAS
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Credential |
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Telephone | 386-585-2951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT24037
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License Number State | FL
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