Provider Demographics
NPI:1134429988
Name:RABEN, LAURA S (MPT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:S
Last Name:RABEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7967 EMERALD WINDS CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-7835
Mailing Address - Country:US
Mailing Address - Phone:561-742-7570
Mailing Address - Fax:
Practice Address - Street 1:4733 W ATLANTIC AVE
Practice Address - Street 2:SUITE C-21
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3706
Practice Address - Country:US
Practice Address - Phone:561-894-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist