Provider Demographics
NPI:1093181976
Name:GEBHARD, CAITLYN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:GEBHARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9759 SAN JOSE BLVD
Mailing Address - Street 2:BUILDING 3, SUITE 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257
Mailing Address - Country:US
Mailing Address - Phone:904-288-0900
Mailing Address - Fax:904-288-0599
Practice Address - Street 1:15255 MAX LEGGETT PKWY STE 4100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7277
Practice Address - Country:US
Practice Address - Phone:904-427-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist