Provider Demographics
NPI:1821588369
Name:ABRAJANO, PAULO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:PAULO
Middle Name:
Last Name:ABRAJANO
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E SUGARLAND HWY
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-3210
Mailing Address - Country:US
Mailing Address - Phone:863-983-9979
Mailing Address - Fax:863-983-5655
Practice Address - Street 1:501 E SUGARLAND HWY
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3210
Practice Address - Country:US
Practice Address - Phone:863-983-9979
Practice Address - Fax:863-983-5655
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32225225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT32225OtherPHYSICAL THERAPY LICENSE