Provider Demographics
NPI:1083986707
Name:ABAD, JOSEPH BENEDICTO (LMT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BENEDICTO
Last Name:ABAD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29605 US 19 N
Mailing Address - Street 2:360
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1539
Mailing Address - Country:US
Mailing Address - Phone:727-784-6088
Mailing Address - Fax:
Practice Address - Street 1:29605 US 19 N
Practice Address - Street 2:360
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1537
Practice Address - Country:US
Practice Address - Phone:727-784-6088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55154225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist