MEDICARE: CORE ESSENTIALS PHYSICAL THERAPY & WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant
2	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1972809143	OTHER	FL	PT NPI

General Provider Information

NPI Number	:	1902544851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE ESSENTIALS PHYSICAL THERAPY & WELLNESS, LLC

Provider Business Mailing Address
First Line	:	1835 3RD ST N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-7469
Country	:	US
Telephone Number	:	904-734-0200
Fax Number	:	888-595-3297

Provider Business Practice Location Address
First Line	:	1835 3RD ST N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-7469
Country	:	US
Telephone Number	:	904-734-0200
Fax Number	:	888-595-3297

Authorized Official
Title or Position	:	CEO
Name	:	JESSICA GROCHOWSKY
Credential	:	PT, DPT, MTC, CLT
Telephone Number	:	386-801-1683

Provider Enumeration Date	:	05/21/2022
Last Update Date	:	04/16/2026

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Directions to “CORE ESSENTIALS PHYSICAL THERAPY & WELLNESS, LLC ” Practice Location

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