Healthcare Provider Details

I. General information

NPI: 1073424149
Provider Name (Legal Business Name): JAKE GEARY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 12TH AVE
MIAMI FL
33136-1087
US

IV. Provider business mailing address

2131 SW 66TH AVE
MIAMI FL
33155-1823
US

V. Phone/Fax

Practice location:
  • Phone: 305-689-1013
  • Fax:
Mailing address:
  • Phone: 248-974-6545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT40713
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: