Provider Demographics
NPI:1154062099
Name:GARRETT, MEGAN NOEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:NOEL
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12203 STEPPINGSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-6257
Mailing Address - Country:US
Mailing Address - Phone:813-951-8868
Mailing Address - Fax:
Practice Address - Street 1:12203 STEPPINGSTONE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-6257
Practice Address - Country:US
Practice Address - Phone:813-951-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist