Healthcare Provider Details

I. General information

NPI: 1063326015
Provider Name (Legal Business Name): PAIGE NARVESON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13459 FISHHAWK BLVD
LITHIA FL
33547-3833
US

IV. Provider business mailing address

11210 VIDA CIR
BRADENTON FL
34211-2882
US

V. Phone/Fax

Practice location:
  • Phone: 813-324-8009
  • Fax:
Mailing address:
  • Phone: 612-805-0364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTT45533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: