Healthcare Provider Details

I. General information

NPI: 1477021939
Provider Name (Legal Business Name): ARNELI ALBA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARNELI ALBA PEREZ PT

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 RIVERSIDE AVE
JACKSONVILLE FL
32202-4912
US

IV. Provider business mailing address

PO BOX 932184
ATLANTA GA
31193-2184
US

V. Phone/Fax

Practice location:
  • Phone: 904-579-2824
  • Fax:
Mailing address:
  • Phone: 856-678-3484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24583
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: