Healthcare Provider Details

I. General information

NPI: 1992402770
Provider Name (Legal Business Name): SENSORY DPT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1646 CORSAIR LN STE 603
MIDDLEBURG FL
32068-8562
US

IV. Provider business mailing address

6360 PLANTATION BAY DR N
JACKSONVILLE FL
32244-5167
US

V. Phone/Fax

Practice location:
  • Phone: 904-458-7655
  • Fax:
Mailing address:
  • Phone: 904-496-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. BEVERLY IVETTE REYES
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 904-458-7655