Individual
JOHN SAMUELRAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-2000
Mailing address
6297 PENDRAGON PL, JACKSONVILLE, FL 32258-9417
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12715
FL
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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