MEDICARE: MRS. MARGARETA M ROES PT

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	PT 6198	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861537268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARETA M ROES PT

Provider Business Mailing Address
First Line	:	2379 RESERVATION RD
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32563-2539
Country	:	US
Telephone Number	:	850-475-0555
Fax Number	:	850-475-0650

Provider Business Practice Location Address
First Line	:	7830 PINE FOREST RD # COTTAGEA
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-8404
Country	:	US
Telephone Number	:	850-741-6715
Fax Number	:	850-204-0489

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	04/29/2024

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