Healthcare Provider Details

I. General information

NPI: 1205297694
Provider Name (Legal Business Name): JENNIFER SATTERLEE BENDER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 SW 75TH ST
GAINESVILLE FL
32607-3453
US

IV. Provider business mailing address

1820 SW 91ST ST
GAINESVILLE FL
32607-3450
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-1900
  • Fax:
Mailing address:
  • Phone: 352-213-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number8149
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: