Provider Demographics
NPI:1659556652
Name:CABISUDO, RONALD YAO (PT)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:YAO
Last Name:CABISUDO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 HWY 441 SE LOT 5
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974
Mailing Address - Country:US
Mailing Address - Phone:347-653-9198
Mailing Address - Fax:
Practice Address - Street 1:84118 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2243
Practice Address - Country:US
Practice Address - Phone:347-653-9198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2019-12-06
Deactivation Date:2009-04-08
Deactivation Code:
Reactivation Date:2019-12-06
Provider Licenses
StateLicense IDTaxonomies
FL24065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist