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General NPI Number Information
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NPI Number | 1659821767
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Entity Type | Individual
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Provider Name | MARGO SLOVIS PT, DPT, CLT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 164 SPANISH MARSH DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32095-7405
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Country | US
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Telephone | 443-983-4627
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Fax |
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Provider Business Mailing Address
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Address Line | 164 SPANISH MARSH DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32095-7405
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Country | US
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Telephone | 443-983-4627
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 31269
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 31269
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 31269
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License Number State | FL
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