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Individual
MR. GARY ROY PABEN
Active
Individual
MR. GARY ROY PABEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT18600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y85581
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/02/2006
Last updated
07/09/2007
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