Provider Demographics
NPI:1891015749
Name:NUNES RABELLO, LUCAS (PT)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:NUNES RABELLO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 NW 24TH BLVD
Mailing Address - Street 2:APT 112
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5654
Mailing Address - Country:US
Mailing Address - Phone:386-538-1288
Mailing Address - Fax:
Practice Address - Street 1:2706 REW CIR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4215
Practice Address - Country:US
Practice Address - Phone:321-842-4800
Practice Address - Fax:321-842-7422
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031467225100000X
FLPT 25109225100000X
FLPT251092251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist