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General NPI Number Information
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NPI Number | 1598054488
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Entity Type | Organization
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Legal Business Name | AB THERAPEUTICS, LLC
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 16236 SW 97TH ST
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City | MIAMI
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State | FL
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Zip | 33196-5942
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Country | US
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Telephone | 305-632-1820
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Fax |
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Provider Business Mailing Address
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Address Line | 16236 SW 97TH ST
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City | MIAMI
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State | FL
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Zip | 33196-5942
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Country | US
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Telephone | 305-632-1820
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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. ARTURO AGUSTIN BOUCUGNANI
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Credential | PT
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Telephone | 305-632-1820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | PT21972
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License Number State | FL
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