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NPI Code Detail

MEDICARE: DR. LOUBENS PHILLIP POLINICE DPT

MEDICARE: DR. LOUBENS PHILLIP POLINICE DPT
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
1225100000XPhysical Therapist41393FL

General Provider Information

NPI Number : 1982469136
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUBENS PHILLIP POLINICE DPT
Provider Business Mailing Address
First Line : 3901 UNIVERSITY BLVD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-4312
Country : US
Telephone Number : 904-345-7251
Fax Number :
Provider Business Practice Location Address
First Line : 1240 W GRANADA BLVD FL 1
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5915
Country : US
Telephone Number : 386-898-0220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2024
Last Update Date : 02/16/2024

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