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General NPI Number Information
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NPI Number | 1801301015
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Entity Type | Organization
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Legal Business Name | ATHLETIX REHAB AND RECOVERY, LLC
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 12/11/2017
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Provider Practice Location Address
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Address Line | 5850 S PINE ISLAND RD
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City | DAVIE
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State | FL
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Zip | 33328-5933
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Country | US
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Telephone | 305-501-0231
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Fax |
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Provider Business Mailing Address
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Address Line | 60 SW 13TH ST APT 4005
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City | MIAMI
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State | FL
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Zip | 33130-4358
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. SHARIF TABBAH
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Credential | DPT, CSCS
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Telephone | 305-501-0231
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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 | 27956
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License Number State | FL
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