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General NPI Number Information
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NPI Number | 1255659769
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Entity Type | Organization
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Legal Business Name | THOMAS P. HABAN, D.C., P.A.
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Dates
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Enumeration Date | 05/07/2010
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Last Update Date | 05/07/2010
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Provider Practice Location Address
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Address Line | 6595 NW 36TH ST SUITE 202
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6979
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Country | US
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Telephone | 305-871-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 6595 NW 36TH ST SUITE 202
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6979
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Country | US
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Telephone | 305-871-3700
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN/OWNER PRES.
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Name | DR. THOMAS PATRICK HABAN
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Credential | D.C.
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Telephone | 305-871-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | ME79374
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH8590
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License Number State | FL
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