Individual
MR. BRIAN JOHN MAHALARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
11701 SAN JOSE BLVD STE 210, JACKSONVILLE, FL 32223-0756
(904) 858-7450
(904) 858-7451
Mailing address
11701 SAN JOSE BLVD STE 210, JACKSONVILLE, FL 32223-0756
(904) 858-7450
(904) 858-7451
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 20758
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889766200
—
FL
Enumeration date
02/14/2007
Last updated
07/08/2007
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