Provider Demographics
NPI:1124362090
Name:TABBAH, SHARIF (DPT)
Entity Type:Individual
Prefix:DR
First Name:SHARIF
Middle Name:
Last Name:TABBAH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 COLLINS AVE APT PH2
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2300
Mailing Address - Country:US
Mailing Address - Phone:203-550-0799
Mailing Address - Fax:
Practice Address - Street 1:20754 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1146
Practice Address - Country:US
Practice Address - Phone:203-550-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist