Provider Demographics
NPI:1164439972
Name:DAKIN, VICKIE M (PT)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:M
Last Name:DAKIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 W SEVILLA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8603
Mailing Address - Country:US
Mailing Address - Phone:813-837-4695
Mailing Address - Fax:813-837-9548
Practice Address - Street 1:3822 W SEVILLA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8603
Practice Address - Country:US
Practice Address - Phone:813-837-4695
Practice Address - Fax:813-837-9548
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 2243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist