Provider Demographics
NPI:1568674778
Name:EVANS, MARGARET MARY (OT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:EVANS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3637 CORTEZ RD W
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3106
Mailing Address - Country:US
Mailing Address - Phone:941-739-7828
Mailing Address - Fax:941-739-7838
Practice Address - Street 1:3637 CORTEZ RD W
Practice Address - Street 2:SUITE 103
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3106
Practice Address - Country:US
Practice Address - Phone:941-739-7828
Practice Address - Fax:941-739-7838
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3364225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist