MEDICARE: SOPHIA GILEVICH

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	44168	FL

General Provider Information

NPI Number	:	1740106558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA GILEVICH

Provider Business Mailing Address
First Line	:	20124 OCEAN KEY DR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33498-4529
Country	:	US
Telephone Number	:	561-990-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 CLINT MOORE RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-2658
Country	:	US
Telephone Number	:	561-994-0014
Fax Number	:

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

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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