Individual
CHARLY MAR CONDINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11565 HARTS RD, JACKSONVILLE, FL 32218-3777
(904) 751-1834
Mailing address
11 E FORSYTH ST APT 805, JACKSONVILLE, FL 32202-3344
(904) 553-6199
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23777
FL
Other
Enumeration date
02/06/2008
Last updated
01/24/2012
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