Provider Demographics
NPI:1720333495
Name:CAVINESS, CHRISTIN M (PT,DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:M
Last Name:CAVINESS
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:M
Other - Last Name:CARLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:3657 CORTEZ RD W STE 110
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3171
Mailing Address - Country:US
Mailing Address - Phone:941-722-4000
Mailing Address - Fax:941-722-4700
Practice Address - Street 1:1401 8TH AVE W STE A
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221
Practice Address - Country:US
Practice Address - Phone:941-722-4000
Practice Address - Fax:941-722-4700
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27560225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist