Individual
ELIZABETH MCGIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4203 SE FEDERAL HWY STE 102, STUART, FL 34997-4925
(772) 223-3440
Mailing address
1732 SW COMFORT ST, PORT ST LUCIE, FL 34987-2026
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19514
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19514
STATE OF FLORIDA DEPARTMENT OF HEALTH
—
Enumeration date
04/02/2012
Last updated
04/02/2012
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