Provider Demographics
NPI:1164807566
Name:MAXIMUM PHYSICAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:MAXIMUM PHYSICAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-269-1799
Mailing Address - Street 1:1915 EAST WEST PARKWAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003
Mailing Address - Country:US
Mailing Address - Phone:904-269-1799
Mailing Address - Fax:904-269-0970
Practice Address - Street 1:1915 EASTWEST PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-6404
Practice Address - Country:US
Practice Address - Phone:904-269-1799
Practice Address - Fax:904-269-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty