NPI Code Details Logo

NPI 1336284199

NPI 1336284199 : DENNIS J. CONLON MPT, DPT : YULEE, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1336284199
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DENNIS J. CONLON MPT, DPT
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/20/2007
-----------------------------------------------------
    Last Update Date     |    12/03/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    463646 STATE ROAD 200 STE 4 
-----------------------------------------------------
    City                 |    YULEE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    32097-0303
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    904-261-4414
-----------------------------------------------------
    Fax                  |    904-261-4614
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6800 SOUTHPOINT PKWY STE 300 
-----------------------------------------------------
    City                 |    JACKSONVILLE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    32216-8203
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    904-634-0460
-----------------------------------------------------
    Fax                  |    904-634-0203
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2251X0800X
-----------------------------------------------------
    Taxonomy Name        |    Orthopedic Physical Therapist
-----------------------------------------------------
    License Number       |    PT19702
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    PT19702
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    2251S0007X
-----------------------------------------------------
    Taxonomy Name        |    Sports Physical Therapist
-----------------------------------------------------
    License Number       |    PT19702
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.