Provider Demographics
NPI:1104793819
Name:PHYSICAL THERAPY ASSOCIATES OF ORANGE PARK, INC
Entity type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES OF ORANGE PARK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HEMANT
Authorized Official - Middle Name:DASHARATHLAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-824-1636
Mailing Address - Street 1:1845 EASTWEST PKWY STE 14
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-6408
Mailing Address - Country:US
Mailing Address - Phone:904-264-6304
Mailing Address - Fax:904-264-6305
Practice Address - Street 1:280 DUNDAS DR STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-5517
Practice Address - Country:US
Practice Address - Phone:904-420-0110
Practice Address - Fax:904-420-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy