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NPI Code Detail

MEDICARE: ZACHARY DANIEL GAUVIN PTA

MEDICARE:   ZACHARY DANIEL GAUVIN  PTA
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
1208100000XPhysical Medicine & Rehabilitation PhysicianPTA29232FL

General Provider Information

NPI Number : 1295294734
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY DANIEL GAUVIN PTA
Provider Business Mailing Address
First Line : 2523 VINSON AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34232-4119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1524 S EAST AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-2324
Country : US
Telephone Number : 941-365-2422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2019
Last Update Date : 03/14/2019

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Directions to “ ZACHARY DANIEL GAUVIN PTA” Practice Location

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