Provider Demographics
NPI:1942505201
Name:BABIAK, ANDREW THEODORE (PT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:THEODORE
Last Name:BABIAK
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:PO BOX 18656
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34276-1656
Mailing Address - Country:US
Mailing Address - Phone:941-349-4453
Mailing Address - Fax:941-924-7402
Practice Address - Street 1:4472 MCASHTON ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2200
Practice Address - Country:US
Practice Address - Phone:941-349-4453
Practice Address - Fax:941-924-7402
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2510225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist