Provider Demographics
NPI:1457686289
Name:DOBBINS, MARCUS DANIEL (DPT)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:DANIEL
Last Name:DOBBINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 S PATRICK DR
Mailing Address - Street 2:STE 3
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4400
Mailing Address - Country:US
Mailing Address - Phone:321-773-5290
Mailing Address - Fax:321-773-5268
Practice Address - Street 1:2030 S PATRICK DR
Practice Address - Street 2:STE 3
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4400
Practice Address - Country:US
Practice Address - Phone:321-773-8155
Practice Address - Fax:321-773-8154
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT-25038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT-25038OtherSTATE OF FL PT LICENSE
FLCL903ZMedicare PIN