Organization
NASSAU PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON MARINO (OFFICE MANAGER)
(904) 277-4449
Entity
Organization
Contact information
Practice address
45390 GREEN AVE, CALLAHAN, FL 32011-3711
(904) 879-1223
(904) 879-1223
Mailing address
PO BOX 1609, CALLAHAN, FL 32011-1609
(904) 879-1223
(904) 879-1223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 5539
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y907M
BLUE CROSS BLUE SHIELD
FL
01
—
Y927Q
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
04/23/2007
Last updated
11/02/2011
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