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General NPI Number Information
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NPI Number | 1548383813
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Entity Type | Individual
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Provider Name | JENNIFER BEAVERS O'NEAL P.T.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3301 SW 34TH CIR SUITE 202
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City | OCALA
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State | FL
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Zip | 34474-6621
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Country | US
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Telephone | 352-237-2292
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Fax | 352-237-2236
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Provider Business Mailing Address
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Address Line | 16110 NW HIGHWAY 225
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City | REDDICK
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State | FL
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Zip | 32686-2634
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Country | US
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Telephone | 352-425-1914
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Fax | 352-237-2292
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT 17247
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License Number State | FL
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