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General NPI Number Information
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NPI Number | 1629553128
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Entity Type | Individual
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Provider Name | JOSEPH JOHN SOBUCKI DPT
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Gender | Male
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 3305 RICE ST
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City | MIAMI
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State | FL
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Zip | 33133-5216
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Country | US
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Telephone | 305-792-8393
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Fax |
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Provider Business Mailing Address
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Address Line | 501 NE 5TH TER APT 414
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-1795
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Country | US
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Telephone | 814-897-6136
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34077
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License Number State | FL
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