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General NPI Number Information
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NPI Number | 1679636245
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Entity Type | Individual
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Provider Name | NOEL CABOT GRESSNER PT, DPT, ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 1222 S DIXIE HWY
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City | CORAL GABLES
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State | FL
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Zip | 33146-2902
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Country | US
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Telephone | 782-467-5175
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Fax | 786-467-5176
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Provider Business Mailing Address
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Address Line | 6705 SW 44TH ST APT 53
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City | MIAMI
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State | FL
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Zip | 33155-4739
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Country | US
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Telephone | 786-200-8282
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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 | 22909
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL 1377
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License Number State | FL
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