Individual
ELIZABETH MARGARET BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
105 MARINER HEALTH WAY STE 213, ST AUGUSTINE, FL 32086-3251
(904) 217-4259
(904) 217-4251
Mailing address
105 MARINER HEALTH WAY STE 213, ST AUGUSTINE, FL 32086-3251
(904) 217-4259
(904) 217-4251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
23557
FL
225100000X
Physical Therapist
Primary
PT36674
FL
225100000X
Physical Therapist
PTP-PT-LIC-9465
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23557
—
FL
Enumeration date
10/05/2007
Last updated
02/15/2021
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