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General NPI Number Information
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NPI Number | 1588676258
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Entity Type | Individual
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Provider Name | ELIZABETH RAE TUBBS PT
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Gender | Female
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 850 NW 86TH AVE APT 519
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City | PLANTATION
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State | FL
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Zip | 33324-1244
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Country | US
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Telephone | 783-606-9021
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Fax |
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Provider Business Mailing Address
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Address Line | 850 NW 86TH AVE APT 519
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City | PLANTATION
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State | FL
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Zip | 33324-1244
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Country | US
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Telephone | 786-606-9021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT8772
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License Number State | FL
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