Provider Demographics
NPI:1467637892
Name:ABASOLO, BRYAN (DC, CNS, CPT)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:ABASOLO
Suffix:
Gender:M
Credentials:DC, CNS, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N. BAYSHORE DRIVE, 1A
Mailing Address - Street 2:SUITE 118
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132
Mailing Address - Country:US
Mailing Address - Phone:305-948-1123
Mailing Address - Fax:305-508-6600
Practice Address - Street 1:1900 N. BAYSHORE DRIVE, 1A
Practice Address - Street 2:SUITE 118
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132
Practice Address - Country:US
Practice Address - Phone:305-948-1123
Practice Address - Fax:305-508-6600
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor