Doctor Name: | MR. GARY ROY PABEN |
NPI Number: | 1689603698 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.P.T. |
License Number: | PT18600 |
Business Practice Address: | 12497 Tamiami Trl S Suite 12 North Port, FL - 342871447 |
Business Phone Number: | 9414263934 |
Business Fax Number: | 9414266718 |
Mailing Address: | 11441 Dancing River Dr, VENICE |
State: | FL |
Postal Code: | 342924127 |
Phone Number: | 9414936979 |
Fax Number: | 9414845487 |
NPI Enumeration Date: | 07/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT18600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |