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General NPI Number Information
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NPI Number | 1932015666
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Entity Type | Individual
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Provider Name | IRELAND SHAE JARVIS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 450 STATE ROAD 13 N
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City | ST JOHNS
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State | FL
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Zip | 32259-3860
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Country | US
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Telephone | 904-900-5512
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Fax |
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Provider Business Mailing Address
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Address Line | 5085 BIG OAK RD S
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32095-6234
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Country | US
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Telephone | 904-563-5655
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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 | 45288
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License Number State | FL
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