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Organization
GAINESVILLE PHYSICAL THERAPY AND REHABILITATION SERVICES INC
Active
Organization
GAINESVILLE PHYSICAL THERAPY AND REHABILITATION SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIBEKE VALA PT (OWNER PRESIDENT)
(352) 376-6300
Entity
Organization
Contact information
Practice address
1234 NW 14TH AVE, GAINESVILLE, FL 32601-4042
(352) 376-6300
(352) 372-0661
Mailing address
1234 NW 14TH AVE, GAINESVILLE, FL 32601-4042
(352) 376-6300
(352) 372-0661
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT12687
FL
225100000X
Physical Therapist
PT3509
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y9125
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/24/2006
Last updated
08/22/2020
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