Provider Demographics
NPI:1255379368
Name:TEAV, CHEUNG TAL (PT)
Entity type:Individual
Prefix:
First Name:CHEUNG
Middle Name:TAL
Last Name:TEAV
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 1:8000 SR 64 E
Mailing Address - Street 2:
Mailing Address - City:COASTAL ORTHOPEDICS & SPORTS MEDICINE OF
Mailing Address - State:FL
Mailing Address - Zip Code:34212
Mailing Address - Country:US
Mailing Address - Phone:941-792-1404
Mailing Address - Fax:941-761-0712
Practice Address - Street 1:8000 SR 64 E
Practice Address - Street 2:
Practice Address - City:COASTAL ORTHOPEDICS & SPORTS MEDICINE OF
Practice Address - State:FL
Practice Address - Zip Code:34212
Practice Address - Country:US
Practice Address - Phone:941-792-1404
Practice Address - Fax:941-761-0712
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00112161OtherRAIL ROAD MEDICARE
FL890855900Medicaid
FLY7854OtherBCBS INDIV PROV NUM
FL7611347OtherGHI INDIV PROV NUM
FLP00429963OtherRAIL ROAD MEDICARE
FLY7854TMedicare PIN
Y7854RMedicare UPIN