Provider Demographics
NPI:1770887929
Name:WEBER, GABRIEL ALBERTO (PT)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ALBERTO
Last Name:WEBER
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 1:150 W MCKENZIE ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-5500
Mailing Address - Country:US
Mailing Address - Phone:941-235-7246
Mailing Address - Fax:941-235-2222
Practice Address - Street 1:150 W MCKENZIE ST
Practice Address - Street 2:SUITE 118
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-5500
Practice Address - Country:US
Practice Address - Phone:941-235-7246
Practice Address - Fax:941-235-2222
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 17445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist