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General NPI Number Information
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NPI Number | 1659774545
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Entity Type | Individual
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Provider Name | SEAN L GORMAN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 630 ATLANTIC BLVD STE 11
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-4003
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Country | US
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Telephone | 904-249-2358
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Fax |
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Provider Business Mailing Address
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Address Line | 1598 COUNTRY WALK DR
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-8669
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Country | US
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Telephone | 804-212-7285
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Fax |
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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 | PT38573
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License Number State | FL
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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 | 2305209063
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License Number State | VA
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