Provider Demographics
NPI:1356822456
Name:ABOUD, JOHN A (DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:ABOUD
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 1:5451 N UNIVERSITY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4641
Mailing Address - Country:US
Mailing Address - Phone:954-796-7001
Mailing Address - Fax:
Practice Address - Street 1:5451 N UNIVERSITY DR STE 103
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4641
Practice Address - Country:US
Practice Address - Phone:954-796-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34622225100000X
IA091378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT34622OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH