Individual
AVEGILLE TABELON UY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1586 BLOOMINGDALE AVE, VALRICO, FL 33596-6101
(813) 978-9700
(813) 558-6044
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0915
(813) 978-9700
(813) 558-6044
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT40144
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00637025
RAILROAD MEDICARE
FL
Enumeration date
10/31/2023
Last updated
01/31/2024
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