Provider Demographics
NPI:1598097867
Name:DEBRA A. RABIDEAU, P.A.
Entity type:Organization
Organization Name:DEBRA A. RABIDEAU, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RABIDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-465-8952
Mailing Address - Street 1:7866 W. SAMPLE RD.
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4710
Mailing Address - Country:US
Mailing Address - Phone:954-465-8952
Mailing Address - Fax:954-341-1134
Practice Address - Street 1:7866 W. SAMPLE RD.
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4710
Practice Address - Country:US
Practice Address - Phone:954-465-8952
Practice Address - Fax:954-341-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty