MEDICARE: DR. MEGAN GRACE DOUBERLY PT, 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
1	225100000X	Physical Therapist	PT44371	FL

General Provider Information

NPI Number	:	1538010673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN GRACE DOUBERLY PT, DPT

Provider Business Mailing Address
First Line	:	2420 DANIELS LANDING DR
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 TAVERNIER DR STE A
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-1270
Country	:	US
Telephone Number	:	904-686-9929
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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