PONTE VEDRA PHYSICAL THERAPY INC. NPI 1043246580

NPI Information

NPI: 1043246580
Provider Name: PONTE VEDRA PHYSICAL THERAPY, INC.
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
880 A1A N
SUITE 18A
PONTE VEDRA BEACH, FL
ZIP 32082
Phone: (904) 285-2910
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PONTE VEDRA PHYSICAL THERAPY, INC. is a rehabilitation clinic center in Ponte Vedra Beach, FL. PONTE VEDRA PHYSICAL THERAPY, INC. NPI is 1043246580. The provider is registered as an organization entity type.

The provider's business location address is:

880 A1A N
SUITE 18A
PONTE VEDRA BEACH, FL
ZIP 32082-221
Phone: (904) 285-2910
Fax: (904) 285-4663

The provider's authorized official is Jeffrey C Parks .
The authorized official title is President and has the following contact phone number (904) 285-2910.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 12/7/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	R9F	OTHER	FLORIDA	BCBS
2	106937	MEDICARE OSCAR/CERTIFICATION	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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