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Organization
INJURY INSTITUTE LLC
Active
Organization
INJURY INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ANTHONY LIVECCHI M.D. (OWNER)
(585) 750-5348
Entity
Organization
Contact information
Practice address
944 ARLINGTON RD N, JACKSONVILLE, FL 32211-5956
(904) 425-9044
(904) 425-9094
Mailing address
793 SANDPIPER LN, PONTE VEDRA, FL 32082-2726
(904) 425-9044
(904) 425-9094
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P0004X
Spinal Cord Injury Medicine Physician
—
NULL
2081P0004X
Spinal Cord Injury Medicine Physician
—
—
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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