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Individual

MICHAEL TABLIZO TABO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1000 W BROADWAY ST, OVIEDO, FL 32765-9260
(321) 841-3760
(321) 841-3232
Mailing address
1000 W BROADWAY ST, OVIEDO, FL 32765-9260
(321) 841-3760
(321) 841-3232

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT33761
FL
2251X0800X
Orthopedic Physical Therapist
Primary
PT33761
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3437
STATE OF NV PT LICENSE NUMBER
NV
01
PT-33761
STATE OF FL PT LICENSE NUMBER
FL
Enumeration date
08/17/2009
Last updated
10/18/2024
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