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General NPI Number Information
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NPI Number | 1376792937
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Entity Type | Organization
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Legal Business Name | CARETENDERS OF JACKSONVILLE LLC
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 1101 PLANTATION ISLAND DR S
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-6191
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Country | US
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Telephone | 904-815-8157
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Fax | 904-376-7624
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-443-4154
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L PROFFITT
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational 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 | 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 #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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