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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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