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General NPI Number Information
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NPI Number | 1093183519
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Entity Type | Organization
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Legal Business Name | INTEGRATED PHYSICAL THERAPY SERVICES OF NORTH FLORIDA, LLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 7230 UNIVERSITY PKWY
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34240-8330
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Country | US
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Telephone | 904-412-2882
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Fax |
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Provider Business Mailing Address
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Address Line | 3948 3RD ST S # 133
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-5847
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Country | US
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Telephone | 904-412-2882
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GREGORY RICHARD CARR
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Credential | DPT
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Telephone | 904-412-2882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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