Provider Demographics
NPI:1699378539
Name:ALBAN, FEDERICO (DPT, PT)
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:
Last Name:ALBAN
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 NW 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2102
Mailing Address - Country:US
Mailing Address - Phone:954-716-1229
Mailing Address - Fax:
Practice Address - Street 1:2647 NW 42ND AVE
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-2102
Practice Address - Country:US
Practice Address - Phone:954-716-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist