Organization
CPT OF JACKSONVILLE INC
Active
Organization
CPT OF JACKSONVILLE INC
Active
Other names
Center For Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM ROGOZINSKI (CEO)
(904) 733-8133
Entity
Organization
Contact information
Practice address
3716 UNIVERSITY BLVD S, SUITE 4, JACKSONVILLE, FL 32216-4355
(904) 733-8133
Mailing address
3716 UNIVERSITY BLVD S, SUITE 4, JACKSONVILLE, FL 32216-4355
(904) 733-8133
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q 34
BLUE CROSS BLUE SHIELD ID
FL
Enumeration date
09/29/2005
Last updated
11/19/2008
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