Provider Demographics
NPI:1083739445
Name:ABOOD, SHEFFIELD T (DC)
Entity Type:Individual
Prefix:
First Name:SHEFFIELD
Middle Name:T
Last Name:ABOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 NW PEACOCK BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2272
Mailing Address - Country:US
Mailing Address - Phone:772-621-4500
Mailing Address - Fax:772-621-4608
Practice Address - Street 1:264 NW PEACOCK BLVD
Practice Address - Street 2:STE 104
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2272
Practice Address - Country:US
Practice Address - Phone:772-621-4500
Practice Address - Fax:772-621-4608
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8854111N00000X, 111NR0200X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0200XChiropractic ProvidersChiropractorRadiology
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89624OtherBC/BS/FL