Provider Demographics
NPI:1255618435
Name:ABBOTT, ANDREW J (MPT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7478 SW 60TH AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6428
Mailing Address - Country:US
Mailing Address - Phone:352-433-1918
Mailing Address - Fax:352-433-0950
Practice Address - Street 1:7478 SW 60TH AVE UNIT A
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6428
Practice Address - Country:US
Practice Address - Phone:352-433-1918
Practice Address - Fax:352-433-0950
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT14651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist