Provider Demographics
NPI:1952420630
Name:RABIDEAU, DEBRA (DC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:RABIDEAU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5663 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-1531
Mailing Address - Country:US
Mailing Address - Phone:954-974-3456
Mailing Address - Fax:
Practice Address - Street 1:5663 NW 29TH ST
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-1531
Practice Address - Country:US
Practice Address - Phone:954-974-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53917Medicare ID - Type Unspecified