Healthcare Provider Details

I. General information

NPI: 1255060604
Provider Name (Legal Business Name): CHRISTOPHER CHARLES ONEAL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10358 RIVERSIDE DR STE 140
PALM BEACH GARDENS FL
33410-4203
US

IV. Provider business mailing address

326 JUPITER LAKES BLVD APT 2308B
JUPITER FL
33458-7168
US

V. Phone/Fax

Practice location:
  • Phone: 904-735-8100
  • Fax:
Mailing address:
  • Phone: 904-735-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number42629
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number42629
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number42629
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: