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NPI Code Detail

MEDICARE: SOPHIE BARGERON DPT

MEDICARE:   SOPHIE  BARGERON  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1871269696
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIE BARGERON DPT
Provider Business Mailing Address
First Line : 705 HOLLY DR
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3578
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 236 PONTE VEDRA PARK DR STE 300
Second Line :
City : PONTE VEDRA BEACH
State : FL
Zip : 32082-6619
Country : US
Telephone Number : 904-280-3440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2021
Last Update Date : 08/20/2021

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Directions to “ SOPHIE BARGERON DPT” Practice Location

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