Individual
DR. EDWARD MALIO SEVERHOF JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4301 S FLAMINGO RD STE 101, DAVIE, FL 33330-1902
(954) 312-3449
Mailing address
1070 54TH AVE N, SAINT PETERSBURG, FL 33703-2744
(419) 574-2522
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467878199
—
FL
Enumeration date
03/05/2014
Last updated
10/13/2022
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