MEDICARE: CARINA M WIKLUND SABA RPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT15261	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669697637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARINA M WIKLUND SABA RPT

Provider Business Mailing Address
First Line	:	420 S DIXIE HWY STE 4D
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2232
Country	:	US
Telephone Number	:	305-856-9000
Fax Number	:	305-856-9910

Provider Business Practice Location Address
First Line	:	420 S DIXIE HWY STE 4D
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2232
Country	:	US
Telephone Number	:	305-856-9000
Fax Number	:	305-856-9910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	06/29/2021

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