Healthcare Provider Details

I. General information

NPI: 1326732678
Provider Name (Legal Business Name): DUVAL SPINE & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9191 R G SKINNER PKWY UNIT 901
JACKSONVILLE FL
32256-9663
US

IV. Provider business mailing address

9191 R G SKINNER PKWY UNIT 901
JACKSONVILLE FL
32256-9663
US

V. Phone/Fax

Practice location:
  • Phone: 904-454-4937
  • Fax:
Mailing address:
  • Phone: 904-454-4937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP SCHEETS JR.
Title or Position: MANAGING PARTNER
Credential: DC
Phone: 904-490-7445