MEDICARE: ANDRIA WILSON PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1821616004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRIA WILSON PT, DPT

Provider Business Mailing Address
First Line	:	3901 UNIVERSITY BLVD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4312
Country	:	US
Telephone Number	:	904-345-7251
Fax Number	:

Provider Business Practice Location Address
First Line	:	11705 SAN JOSE BLVD STE 111
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-1653
Country	:	US
Telephone Number	:	904-345-7450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	07/14/2020

Similar Medicare Providers

1942371240 — MR. MATTHEW J GILES PA-C
Practice Location Address:

11705 SAN JOSE BLVD STE 103
JACKSONVILLE, FL
32223-1653

Practice Phone: 904-880-0911
Practice Fax: 904-880-9388

1457879371 — DR. SHELBY FUENTES PT, DPT
Practice Location Address:

11705 SAN JOSE BLVD STE 111
JACKSONVILLE, FL
32223-1653

Practice Phone: 904-345-7450
Practice Fax:

1568955300 — DR. ELIZABETH USEDOM ROGOZINSKI MD
Practice Location Address:

11705 SAN JOSE BLVD STE 210
JACKSONVILLE, FL
32223-1653

Practice Phone: 904-594-2755
Practice Fax: 904-515-6437

1437751781 — TAKIM HENRY DPT
Practice Location Address:

11705 SAN JOSE BLVD STE 111
JACKSONVILLE, FL
32223-1653

Practice Phone: 904-345-7450
Practice Fax:

1770156515 — CRYSTAL MORGAN JAIN PT, DPT
Practice Location Address:

11705 SAN JOSE BLVD STE 111
JACKSONVILLE, FL
32223-1653

Practice Phone: 904-345-7450
Practice Fax:

1023783669 — ELIZABETH MOORE PT, DPT
Practice Location Address:

11705 SAN JOSE BLVD STE 111
JACKSONVILLE, FL
32223-1653

Practice Phone: 904-345-7450
Practice Fax:

Directions to “ ANDRIA WILSON PT, DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.