| |
3488 Gasparilla St, St James City, FL 33956-2540 | |
(239) 745-1631 | |
(239) 282-2108 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 3488 Gasparilla St, St James City, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215080742 | NPI | - | NPPES |
1114096229 | Other | FL | INDIVIDUAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 7166 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
3488 Gasparilla St, St James City, FL 33956-2540 Ph: (239) 745-1631 | 3488 Gasparilla St, St James City, FL 33956-2540 Ph: (239) 745-1631 |