Healthcare Provider Details

I. General information

NPI: 1649312539
Provider Name (Legal Business Name): H2 THERAPY PROVIDER NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

554 KINGSLEY AVE
ORANGE PARK FL
32073-4830
US

IV. Provider business mailing address

484 RIVERSIDE AVE # A
JACKSONVILLE FL
32202-4912
US

V. Phone/Fax

Practice location:
  • Phone: 866-530-3940
  • Fax: 904-757-9680
Mailing address:
  • Phone: 800-699-9395
  • Fax: 904-944-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE ADAMS
Title or Position: CHIEF EXECUTIVE OFFICER/AO
Credential:
Phone: 904-944-4062