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General NPI Number Information
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NPI Number | 1285827352
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Entity Type | Organization
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Legal Business Name | CABELLO GROUPO SERVICIO CORP
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 1032 S MILITARY TRL
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-4717
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Country | US
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Telephone | 561-433-4051
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Fax | 561-433-4052
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Provider Business Mailing Address
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Address Line | 1032 S MILITARY TRL
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-4717
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Country | US
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Telephone | 561-433-4051
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Fax | 561-433-4052
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MIGUEL CABELLO
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Credential |
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Telephone | 561-433-4051
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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 | HCC7203
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License Number State | FL
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