Provider Demographics
NPI:1609075340
Name:ABLE BODY CARE
Entity Type:Organization
Organization Name:ABLE BODY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:ROBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-812-2548
Mailing Address - Street 1:3003 MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3430
Mailing Address - Country:US
Mailing Address - Phone:727-812-2548
Mailing Address - Fax:727-812-2548
Practice Address - Street 1:3003 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-3430
Practice Address - Country:US
Practice Address - Phone:727-812-2548
Practice Address - Fax:727-812-2548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL685434600251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL685434603Medicaid
FL685434696Medicaid
FL685434698Medicaid