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General NPI Number Information
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NPI Number | 1255508008
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Entity Type | Organization
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Legal Business Name | SMART BODY PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 11555 CENTRAL PKWY STE 202
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2693
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Country | US
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Telephone | 904-296-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 11555 CENTRAL PKWY STE 202
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2693
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Country | US
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Telephone | 904-296-4140
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Fax | 904-279-0963
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA BUNSO
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Credential |
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Telephone | 904-382-3804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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