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General NPI Number Information
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NPI Number | 1821279852
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Entity Type | Individual
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Provider Name | ABIGAIL TUBIO
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Gender | Female
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 1455 FL-436 SUITE #101
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City | CASSELBERRY
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State | FL
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Zip | 32707
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Country | US
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Telephone | 407-708-9228
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Fax |
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Provider Business Mailing Address
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Address Line | 2502 N ROCKY POINT DR STE 1000
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City | TAMPA
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State | FL
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Zip | 33607-1449
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Country | US
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Telephone | 813-288-1999
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN18195
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License Number State | FL
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