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General NPI Number Information
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NPI Number | 1750317160
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Entity Type | Organization
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Legal Business Name | JOSEPH E GILLESPIE INC
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 5400 CHAMPION BLVD
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City | BOCA RATON
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State | FL
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Zip | 33496-1607
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Country | US
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Telephone | 561-912-1014
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Fax | 561-955-1222
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Provider Business Mailing Address
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Address Line | 5030 CHAMPION BLVD SUITE G11-279
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City | BOCA RATON
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State | FL
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Zip | 33496-2473
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Country | US
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Telephone | 561-715-8958
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. JOANNE GILLESPIE
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Credential |
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Telephone | 770-965-1079
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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 | PT19896
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License Number State | FL
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