MEDICARE: PELVIC SOLUTIONS, PLLC

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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1780447425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PELVIC SOLUTIONS, PLLC

Provider Business Mailing Address
First Line	:	2915 N BOULEVARD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-1207
Country	:	US
Telephone Number	:	813-992-6656
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 N BOULEVARD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-1207
Country	:	US
Telephone Number	:	813-992-6656
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTEN DAIGLE
Credential	:	OTD, OTR/L
Telephone Number	:	813-830-3647

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/05/2024

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