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Individual

MS. CHRISTINA MARIE LONGOBUCCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
4203 BELFORT RD, JACKSONVILLE, FL 32216-1409
(904) 296-3711
(904) 296-4088
Mailing address
4203 BELFORT RD, SUITE 115, JACKSONVILLE, FL 32216-1409
(904) 296-3711
(904) 296-4088

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT18224
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00049736
RAILROAD MEDICARE
FL
01
Y035U
BLUECROSS/BLUESHIELD
FL
Enumeration date
11/23/2005
Last updated
04/09/2010
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