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General NPI Number Information
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NPI Number | 1770683583
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Entity Type | Individual
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Provider Name | JOSE JOAQUIN STABLE PT,PTA.,LMT
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 2602 N FEDERAL HWY
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-2413
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Country | US
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Telephone | 561-738-6691
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Fax | 561-777-7878
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Provider Business Mailing Address
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Address Line | 2602 N FEDERAL HWY
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-2413
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Country | US
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Telephone | 561-738-6691
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Fax | 561-777-7878
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA 18956
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA35991
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT32333
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License Number State | FL
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