Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH8854 | FL |
N | 111NR0200X | Radiology | CH8854 | FL |
N | 213ER0200X | Radiology | CH8854 | FL |
N | 111NR0400X | Rehabilitation Chiropractor | CH8854 | FL |
NPI | 1083739445 |
---|---|
Provider Name | Sheffield T Abood |
First Address | Port St Lucie, FL 34986-2272 |
Second Address | Port St Lucie, FL 34986-2272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 27/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89624 | BC/BS/FL (01) | FL |