Organization

Physical Healthcare Of Jacksonville Inc

Legal Business Name

Physical Healthcare Of Jacksonville Inc

NPI Number

1760722011

NPI Type

Organization

Enumeration Date

02/25/2013

Specialties

(Taxonomies)

Licenses

State

Florida
Florida
Florida
Florida
Florida
Florida
Florida
Florida

License Number

CH6451
CH6588
CH4435
ME55161
ME0060908
ARNP 770742
PA9106788
PT30658

Contact
Information

Purpose

Mailing
Location

Address

12620 BEACH BLVD
12620 BEACH BLVD

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32246-7131
32246-7131

Country

US
US

Telephone Number

(904) 645-0777
(904) 645-0777

Authorized Official

Name

Mark Pierce

Title or Position

CLINIC DIRECTOR

Telephone Number

(904) 645-0777

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/18/2017

Provider Address