Provider Demographics
NPI:1427148592
Name:WEBER, ABIGAIL LEIGH (LAT, ATC, OTC)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:LEIGH
Last Name:WEBER
Suffix:
Gender:F
Credentials:LAT, ATC, OTC
Other - Prefix:MISS
Other - First Name:ABIGAIL
Other - Middle Name:LEIGH
Other - Last Name:BAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:900 VILLAGE SQUARE XING STE 170
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4549
Mailing Address - Country:US
Mailing Address - Phone:615-627-8500
Mailing Address - Fax:
Practice Address - Street 1:3450 11TH CT STE 302
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5012
Practice Address - Country:US
Practice Address - Phone:772-794-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0904021932255A2300X
MN19842255A2300X
21-0423246ZX2200X
FL61422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant