Provider Demographics
NPI:1821371337
Name:GARCIA-ABALO, FELIX D
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:D
Last Name:GARCIA-ABALO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11520 SW 81ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3612
Mailing Address - Country:US
Mailing Address - Phone:786-395-8735
Mailing Address - Fax:305-742-2190
Practice Address - Street 1:11520 SW 81ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3612
Practice Address - Country:US
Practice Address - Phone:786-395-8735
Practice Address - Fax:305-742-2190
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLMA 56546225700000X
FLPTA27278225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPTA27278OtherLICENSE
FLMA 56546OtherLICENSE