Provider Demographics
NPI:1811209372
Name:SABADO, NICHOLE RHAE (PT, DPT, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:RHAE
Last Name:SABADO
Suffix:
Gender:F
Credentials:PT, DPT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 COMMERCE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4202
Mailing Address - Country:US
Mailing Address - Phone:321-305-6567
Mailing Address - Fax:321-806-3284
Practice Address - Street 1:389 COMMERCE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955
Practice Address - Country:US
Practice Address - Phone:321-305-6567
Practice Address - Fax:321-806-3284
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL28462255A2300X
FLPT30101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer