MEDICARE: MARY L BIXLER

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
1	225200000X	Physical Therapy Assistant	PTA18842	FL

General Provider Information

NPI Number	:	1053276477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY L BIXLER

Provider Business Mailing Address
First Line	:	1991 DAVENPORT BLVD
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-9201
Country	:	US
Telephone Number	:	863-679-3338
Fax Number	:	863-455-7049

Provider Business Practice Location Address
First Line	:	1991 DAVENPORT BLVD
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-9201
Country	:	US
Telephone Number	:	863-679-3338
Fax Number	:	863-455-7049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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Directions to “ MARY L BIXLER ” Practice Location

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