Provider Demographics
NPI:1346489978
Name:ACOL, REYNALDO ALBA (RPT)
Entity Type:Individual
Prefix:MR
First Name:REYNALDO
Middle Name:ALBA
Last Name:ACOL
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4427 67TH AVENUE CIR E
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-5194
Mailing Address - Country:US
Mailing Address - Phone:941-720-4776
Mailing Address - Fax:
Practice Address - Street 1:4427 67TH AVENUE CIR E
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-5194
Practice Address - Country:US
Practice Address - Phone:941-720-4776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist