Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT8940 | FL |
Y | 2251G0304X | Physical Therapist - Geriatrics | 8940 | TX |
NPI | 1114262995 |
---|---|
Provider Name | Mrs. Teresa Ceciliasheila Abangan-Belo |
First Address | Bradenton, FL 34203-7185 |
Second Address | Bradenton, FL 34203-7185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2012 |
Last Update Date | 04/11/2015 |