Provider Demographics
NPI:1013031467
Name:SABULAO, RICO KINTANAR (PT)
Entity Type:Individual
Prefix:MR
First Name:RICO
Middle Name:KINTANAR
Last Name:SABULAO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6649 MARBELLA LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-5048
Mailing Address - Country:US
Mailing Address - Phone:914-844-7537
Mailing Address - Fax:
Practice Address - Street 1:6649 MARBELLA LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5048
Practice Address - Country:US
Practice Address - Phone:914-844-7537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT37418225100000X
NY0110548-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist