Provider Demographics
NPI:1669208435
Name:DAVIDSON, SARA PRESTON (DPT, PT)
Entity type:Individual
Prefix:
First Name:SARA PRESTON
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 ABBEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1602
Mailing Address - Country:US
Mailing Address - Phone:727-482-4295
Mailing Address - Fax:
Practice Address - Street 1:2349 SUNSET POINT RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1456
Practice Address - Country:US
Practice Address - Phone:727-723-8457
Practice Address - Fax:727-723-8467
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist