Individual
ANGELA MARIA RESTIVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2180 A1A S, ST AUGUSTINE, FL 32080-6591
(443) 257-3085
Mailing address
110 2ND ST, ST AUGUSTINE, FL 32080-6369
(443) 257-3085
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
MA85843
FL
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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